title: Testosterone prescribing in the population-a short social epidemiological analysis in Sweden.
abstract: OBJECTIVE
  In recent years, there has been an increased interest for use of pharmaceutical testosterone among elderly men. However, it is still scarcely studied if this use is conditioned by socioeconomic factors in the general population of elderly men.
  
  
  METHODS
  Using individual-level data from a population-based cohort of men aged 65-84 years in the County Scania, Sweden, we analysed testosterone use in 2006 in relation to demographic and socioeconomic factors by means of multiple logistic regression. We also analysed national data at the ecological level to investigate trends in prescribing between 2006 and 2014.
  
  
  RESULTS
  The prevalence of testosterone use in Sweden among 65- to 84-year-old men increased by 83%, from 3.3 per 1000 men in 2006 to 6.0 in 2014. Testosterone use was more than twice as common in men in the highest income quintile compared with those in the lowest (0.68% versus 0.25%, odds ratio 2.69 and 95% confidence interval 1.80-4.02). Besides in the high-income group, testosterone use was highest in 65- to 69-year-old men, divorced men and, specially, in men with a previous hospital diagnose of hypogonadism.
  
  
  CONCLUSIONS
  Our findings show socioeconomic inequities in prescription of testosterone. This is a short analysis based on limited data, but because information on this topic is scarce, our analysis adds a relevant piece of evidence and highlights the need for further research.
authors.affiliation: Unit for Social Epidemiology, Faculty of Medicine, Lund University, Lund, Sweden.
authors.forename: Pernilla J
authors.identifier: http://orcid.org/0000-0003-4616-9525
authors.initials: PJ
authors.lastname: Bjerkeli
authors.affiliation: Unit for Social Epidemiology, Faculty of Medicine, Lund University, Lund, Sweden.|Department of Sociology, Faculty of Social Sciences, Lund University, Lund, Sweden.
authors.forename: Shai
authors.initials: S
authors.lastname: Mulinari
authors.affiliation: Unit for Social Epidemiology, Faculty of Medicine, Lund University, Lund, Sweden.
authors.forename: Juan
authors.initials: J
authors.lastname: Merlo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D016017:Odds Ratio; D015995:Prevalence; D012042:Registries; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy / Q000453:epidemiology; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology; D013739:Testosterone / Q000627:therapeutic use*
chemical_list: D013739:Testosterone
keywords: Testosterone; drug utilisation research; hypogonadism; off-label use; pharmacoepidemiology