title: Using Big Data to Assess Prescribing Patterns in Greece: The Case of Chronic Obstructive Pulmonary Disease.
abstract: Chronic Obstructive Pulmonary Disease (COPD) is one of the top leading causes of death and disability, and its management is focused on reducing risk factors, relieving symptoms, and preventing exacerbations. The study aim was to describe COPD prescribing patterns in Greece by using existing health administrative data for outpatients.
  
  
  
  This is a retrospective cross-sectional study based on prescriptions collected by the largest social insurance fund, during the first and last trimester of 2012. Selection criteria were the prescription of specific active substances and a COPD diagnosis. Extracted information included active substance, strength, pharmaceutical form and number of packages prescribed, diagnosis, time of dispensing, as well as insurees' age, gender, percentage of co-payment and social security unique number. Statistical analysis included descriptive statistics and logistic regression.
  
  
  
  174,357 patients received medicines for COPD during the study period. Patients were almost equally distributed between male and female, and age above 55 years was strongly correlated with COPD. Most patients received a long-acting beta agonist plus inhaled corticosteroid combination (LABA +ICS), followed by long-acting muscarinic agonist (LAMA). 63% patients belonging in the 35-54 age received LABA+ICS. LAMA was prescribed more frequently among males and was strongly correlated with COPD.
  
  
  
  The study provides big data analysis of Greek COPD prescribing patterns. It highlights the need for appropriate COPD classification in primary care illustrating the role of electronic prescribing in ensuring appropriate prescribing. Moreover, it indicates possible gender differences in treatment response or disease severity, and the impact of statutory co-payments on prescribing.
authors.affiliation: Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece.|Centre for Health Services Research, Medical School, University of Athens, Athens, Greece.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Souliotis
authors.affiliation: Medicines Division, National Organization for Healthcare Services Provision (EOPYY), Athens, Greece.
authors.forename: Chara
authors.initials: C
authors.lastname: Kani
authors.affiliation: Department of Social and Educational Policy, University of Peloponnese, Corinth, Greece.
authors.forename: Manto
authors.initials: M
authors.lastname: Papageorgiou
authors.affiliation: Department of Social and Educational Policy, University of Peloponnese, Corinth, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Lionis
authors.affiliation: Department of Respiratory Medicine, Medical School. University of Thessaly, Larissa, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Gourgoulianis
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D000328:Adult; D000367:Age Factors; D000368:Aged; D004359:Drug Therapy, Combination / Q000706:statistics & numerical data; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D018721:Muscarinic Agonists / Q000008:administration & dosage; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012737:Sex Factors; D012943:Social Security / Q000706:statistics & numerical data
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018721:Muscarinic Agonists