title: Time trends of period prevalence rates of patients with inhaled long-acting beta-2-agonists-containing prescriptions: a European comparative database study.
abstract: BACKGROUND
  Inhaled, long-acting beta-2-adrenoceptor agonists (LABA) have well-established roles in asthma and/or COPD treatment. Drug utilisation patterns for LABA have been described, but few studies have directly compared LABA use in different countries. We aimed to compare the prevalence of LABA-containing prescriptions in five European countries using a standardised methodology.
  
  
  METHODS
  A common study protocol was applied to seven European healthcare record databases (Denmark, Germany, Spain, the Netherlands (2), and the UK (2)) to calculate crude and age- and sex-standardised annual period prevalence rates (PPRs) of LABA-containing prescriptions from 2002-2009. Annual PPRs were stratified by sex, age, and indication (asthma, COPD, asthma and COPD).
  
  
  RESULTS
  From 2002-2009, age- and sex-standardised PPRs of patients with LABA-containing medications increased in all databases (58.2%-185.1%). Highest PPRs were found in men ≥ 80 years old and women 70-79 years old. Regarding the three indications, the highest age- and sex-standardised PPRs in all databases were found in patients with "asthma and COPD" but with large inter-country variation. In those with asthma or COPD, lower PPRs and smaller inter-country variations were found. For all three indications, PPRs for LABA-containing prescriptions increased with age.
  
  
  CONCLUSIONS
  Using a standardised protocol that allowed direct inter-country comparisons, we found highest rates of LABA-containing prescriptions in elderly patients and distinct differences in the increased utilisation of LABA-containing prescriptions within the study period throughout the five European countries.
authors.affiliation: Institute for Medical Information Sciences, Biometry, and Epidemiology, Ludwig-Maximilians-Universitaet Muenchen, Munich, Germany.
authors.forename: Marietta
authors.initials: M
authors.lastname: Rottenkolber
authors.affiliation: Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands; Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
authors.forename: Eef
authors.initials: E
authors.lastname: Voogd
authors.affiliation: Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands; Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
authors.forename: Liset
authors.initials: L
authors.lastname: van Dijk
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Paola
authors.initials: P
authors.lastname: Primatesta
authors.affiliation: Division Clinical Pharmacy & Epidemiology, University of Basel, Basel, Switzerland.
authors.forename: Claudia
authors.initials: C
authors.lastname: Becker
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Raymond
authors.initials: R
authors.lastname: Schlienger
authors.affiliation: Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.
authors.forename: Mark C H
authors.initials: MC
authors.lastname: de Groot
authors.affiliation: European Medicines Agency, London, United Kingdom.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Alvarez
authors.affiliation: European Medicines Agency, London, United Kingdom.
authors.forename: Julie
authors.initials: J
authors.lastname: Durand
authors.affiliation: European Medicines Agency, London, United Kingdom.
authors.forename: Jim
authors.initials: J
authors.lastname: Slattery
authors.affiliation: Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.
authors.forename: Ana
authors.initials: A
authors.lastname: Afonso
authors.affiliation: Pharmacology Unit, Department of Biomedical Sciences II, School of Medicine and Health Sciences, University of Alcalá, Madrid, Spain.
authors.forename: Gema
authors.initials: G
authors.lastname: Requena
authors.affiliation: BIFAP Unit, Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Madrid, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Gil
authors.affiliation: BIFAP Unit, Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Madrid, Spain.
authors.forename: Arturo
authors.initials: A
authors.lastname: Alvarez
authors.affiliation: Danish Medicines Agency (Lægemiddelstyrelsen), Medicines Control Division, Copenhagen, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Hesse
authors.affiliation: National Association of Statutory Health Insurance Physicians of Bavaria, Munich, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Gerlach
authors.affiliation: Institute for Medical Information Sciences, Biometry, and Epidemiology, Ludwig-Maximilians-Universitaet Muenchen, Munich, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Hasford
authors.affiliation: Medizinische Klinik und Poliklinik V, University Hospital, Ludwig-Maximilians-Universitaet Muenchen, Munich, Germany.
authors.forename: Rainald
authors.initials: R
authors.lastname: Fischer
authors.affiliation: Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.
authors.forename: Olaf H
authors.initials: OH
authors.lastname: Klungel
authors.affiliation: Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany; Philipp Klee-Institute for Clinical Pharmacology, HELIOS Clinic Wuppertal, Wuppertal, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Schmiedl
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000188:drug therapy / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005060:Europe; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D055553:Prescription Drugs / Q000008:administration & dosage*; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000378:metabolism; D018343:Receptors, Adrenergic, beta-2 / Q000378:metabolism; D055815:Young Adult
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D055553:Prescription Drugs; D018343:Receptors, Adrenergic, beta-2