1 Det Sundhedsvidenskabelige Fakultet, SDU2 Research Unit for General Practice in Odense, Department of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU3 Register/Ulykker/Hjerter, National Institute of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU4 Research Unit of General Practice, Department of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU5 Register/Ulykker/Hjerter, National Institute of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU6 Research Unit of General Practice, Department of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU
Supported by the growing evidence of the beneficial effects of statins in a range of conditions, statin utilization has increased considerably in most Western countries over the last decade. Objectives To estimate to what extent a widening of indication scope for statins accounts for the increasing Danish statin utilization during 1996-2005, applying treatment incidence as a measure of changing prescribing behaviour Methods From three nationwide registers, we retrieved individual records on demographics, dispensed prescription drugs and hospital discharges. Danish inhabitants were followed with respect to dispensed prescriptions of cardiovascular drugs and antidiabetica during 1996-2005 and with respect to discharge diagnoses and surgical procedures performed during 1977-2005. The disease status for all cohort members during the observation period was assigned by means of disease markers for seven cardiovascular conditions, corresponding to a hierarchy of statin indications. Poisson regression analyses were applied to quantify the incidence growth, according to age and indication. Results Treatment incidence increased from 4/1000 person years in 2000 to 17/1000 in 2005, the increase being slow until 2000. The relative increase was largest among those with no disease markers and lowest among those with ischemic heart disease. The largest growth was found among the elderly (75+) with no disease markers. Conclusions Growing statin utilization reflects the broader range of condition for initiating statin treatment, including the "abolition of ageism". The fact that treatment incidence grew most among elderly without disease markers reflects a changing prescribing behaviours among general practitioners, presumably related to an increased use of risk scoring.