title: Drug prescription patterns in patients with Addison's disease: a Swedish population-based cohort study.
abstract: BACKGROUND
  There are no published data on drug prescription in patients with Addison's disease (AD).
  
  
  OBJECTIVE
  Our objective was to describe the drug prescription patterns in Swedish AD patients before and after diagnosis compared with population controls.
  
  
  METHODS
  We conducted a population-based cohort study in Sweden.
  
  
  METHODS
  Through the Swedish National Patient Register and the Swedish Prescribed Drug Register, we identified 1305 patients with both a diagnosis of AD and on combination treatment with hydrocortisone/cortisone acetate and fludrocortisone. Direct evidence of the AD diagnosis from patient charts was not available. We identified 11 996 matched controls by the Register of Population.
  
  
  METHODS
  We determined the ratio of observed to expected number of patients treated with prescribed drugs.
  
  
  RESULTS
  Overall, Swedish AD patients received more prescribed drugs than controls, and 59.3% of the AD patients had medications indicating concomitant autoimmune disease. Interestingly, both before and after the diagnosis of AD, patients used more gastrointestinal medications, antianemic preparations, lipid-modifying agents, antibiotics for systemic use, hypnotics and sedatives, and drugs for obstructive airway disease (all P values < .05). Notably, an increased prescription of several antihypertensive drugs and high-ceiling diuretics was observed after the diagnosis of AD.
  
  
  CONCLUSIONS
  Gastrointestinal symptoms and anemia, especially in conjunction with autoimmune disorders, should alert the physician about the possibility of AD. The higher use of drugs for cardiovascular disorders after diagnosis in patients with AD raises concerns about the replacement therapy.
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-171 76 Stockholm, Sweden. Sigridur.bjornsdottir@ki.se
authors.forename: Sigridur
authors.initials: S
authors.lastname: Björnsdottir
authors.forename: Anders
authors.initials: A
authors.lastname: Sundström
authors.forename: Jonas F
authors.initials: JF
authors.lastname: Ludvigsson
authors.forename: Paul
authors.initials: P
authors.lastname: Blomqvist
authors.forename: Olle
authors.initials: O
authors.lastname: Kämpe
authors.forename: Sophie
authors.initials: S
authors.lastname: Bensing
mesh_terms: D000224:Addison Disease / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy; D015331:Cohort Studies; D004232:Diuretics / Q000627:therapeutic use; D011307:Drug Prescriptions; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006397:Hematinics / Q000627:therapeutic use; D020249:Hormone Replacement Therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D012042:Registries; D013548:Sweden / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones; D000959:Antihypertensive Agents; D004232:Diuretics; D005765:Gastrointestinal Agents; D006397:Hematinics; D007166:Immunosuppressive Agents