title: Sixteen-year nationwide trends in antithrombotic drug use in Denmark and its correlation with landmark studies.
abstract: Antithrombotic drugs are widely used in the prevention and treatment of cardiovascular diseases; yet, nationwide long-term usage trends remain unexplored. We examined long-term trends in the use of antithrombotic drugs in Denmark.
  
  
  
  Using nationwide prescription data, we obtained information on primary care use of antiplatelet drugs, vitamin K antagonists (VKA), non-vitamin K antagonist oral anticoagulants (NOAC), heparins and fondaparinux during 1999-2014.
  
  
  
  During the 16-year period, the use of antithrombotic drugs per 1000 inhabitants/day increased from 64 to 96 defined daily doses (DDD), and the prevalence proportion of users doubled from 5.1% to 9.6% of the Danish population. From 1999 to 2014, there was an increased use of both antiplatelet drugs (from 60 to 79 DDD per 1000 inhabitants/day) and VKA (from 4 to 9 DDD per 1000 inhabitants/day). NOAC was marketed in 2008 and had an abrupt rise in use to 8 DDD per 1000 inhabitants/day in 2014. The use of heparins and fondaparinux increased slightly during the study period (from 0 to 0.6 DDD per 1000 inhabitants/day). Hospital use of antithrombotic drugs also increased during the study period, but constituted a minor part of the total use (4 DDD per 1000 inhabitants/day in 2014).
  
  
  
  Considerable changes have occurred in the use of antithrombotic drugs during the past 16 years, including the introduction of several new and increasingly used treatment modalities such as NOAC. The trends in use of individual drugs correlate well with the publication of landmark studies.
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.|Department of Cardiology, Aarhus University Hospital, Denmark.
authors.forename: Kasper
authors.initials: K
authors.lastname: Adelborg
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Denmark.|Faculty of Health, Institute of Clinical Medicine, Aarhus University, Denmark.
authors.forename: Erik Lerkevang
authors.identifier: 0000-0002-1466-0865
authors.initials: EL
authors.lastname: Grove
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.|Department of Cardiology, Aarhus University Hospital, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Sundbøll
authors.affiliation: Department of Data Delivery and Medicinal Product Statistics, The Danish Health Data Authority, Denmark.
authors.forename: Maja
authors.initials: M
authors.lastname: Laursen
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.|Department of Internal Medicine, Regional Hospital of Randers, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Schmidt
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D003718:Denmark; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D000077425:Fondaparinux; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011134:Polysaccharides / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011320:Primary Health Care / Q000639:trends; D012042:Registries; D013997:Time Factors; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D011134:Polysaccharides; D006493:Heparin; D000077425:Fondaparinux