title: Drugs prescribed by general practitioners according to age, gender and socioeconomic status after adjustment for multimorbidity level.
abstract: BACKGROUND
  Age, gender and socioeconomic status have been shown to be associated with the use of prescription drugs, even after adjustment for multimorbidity. General practitioners have a holistic and patient-centred perspective and our hypothesis is that this may reflect on the prescription of drugs. In Sweden the patient may seek secondary care without a letter of referral and the liability of the prescription of drugs accompanies the patient, which makes it suitable for this type of research. In this study we examine the odds of having prescription drug use in the population and the rates of prescription drugs among patients, issued in primary health care, according to age, gender and socioeconomic status after adjustment for multimorbidity level.
  
  
  METHODS
  Data were collected on all individuals above 20 years of age in Östergötland county with about 400 000 inhabitants in year 2006. The John Hopkins ACG Case-mix was used as a proxy for multimorbidity level. Odds ratio (OR) of having prescription drugs issued in primary health care in the population and rates of prescription drug use among patients in primary health care, stated as incidence rate ratio (IRR), according to age, gender and socioeconomic status were calculated and adjusted for multimorbidity.
  
  
  RESULTS
  After adjustment for multimorbidity, individuals 80 years or older had higher odds ratio (OR 3.37 (CI 95% 3.22-3.52)) and incidence rate ratio (IRR 6.24 (CI 95% 5.79-6.72)) for prescription drug use. Male individuals had a lower odds ratio of having prescription drugs (OR 0.66 (CI 95% 0.64-0.69)), but among patients males had a slightly higher incidence rate of drug use (IRR 1.06 (CI 95% 1.04-1.09)). Individuals with the highest income had the lowest odds ratio of having prescription drugs and individuals with the second lowest income had the highest odds ratio of having prescription drugs (OR 1.10 (CI 95% 1.07-1.13)). Individuals with the highest education had the lowest odds ratio of having prescription drugs (OR 0.61 (CI 95% 0.54-0.67)).
  
  
  CONCLUSIONS
  Age, gender and socioeconomic status are associated with large differences in the use of prescribed drugs in primary health care, even after adjustment for multimorbidity level.
authors.affiliation: Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden. jessica.skoog@med.lu.se.
authors.forename: Jessica
authors.initials: J
authors.lastname: Skoog
authors.affiliation: Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden. patrik.midlov@med.lu.se.
authors.forename: Patrik
authors.initials: P
authors.lastname: Midlöv
authors.affiliation: Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden. anders.beckman@med.lu.se.
authors.forename: Anders
authors.initials: A
authors.lastname: Beckman
authors.affiliation: Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden. jan.sundquist@med.lu.se.|Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA. jan.sundquist@med.lu.se.
authors.forename: Jan
authors.initials: J
authors.lastname: Sundquist
authors.affiliation: Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden. anhalling@health.sdu.dk.|Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, DK-5000, Odense C, Denmark. anhalling@health.sdu.dk.
authors.forename: Anders
authors.initials: A
authors.lastname: Halling
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D058006:General Practice; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000627:therapeutic use*; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D013548:Sweden; D055815:Young Adult
chemical_list: D055553:Prescription Drugs