Changes in the Use of Hydrochlorothiazide and Other Antihypertensive Drugs in Switzerland in Association With the Swissmedic Safety Alert Regarding Non-melanoma Skin Cancer: An Interrupted Time-Series Analysis Using Swiss Claims Data.
Humans
Switzerland
/ epidemiology
Hydrochlorothiazide
/ adverse effects
Antihypertensive Agents
/ adverse effects
Interrupted Time Series Analysis
Skin Neoplasms
/ epidemiology
Male
Female
Middle Aged
Aged
Databases, Factual
/ statistics & numerical data
Adult
Angiotensin-Converting Enzyme Inhibitors
/ adverse effects
Angiotensin Receptor Antagonists
/ adverse effects
Hypertension
/ drug therapy
Swissmedic
direct healthcare professional communication
drug utilisation study
hydrochlorothiazide
non‐melanoma skin cancer
Journal
Pharmacoepidemiology and drug safety
ISSN: 1099-1557
Titre abrégé: Pharmacoepidemiol Drug Saf
Pays: England
ID NLM: 9208369
Informations de publication
Date de publication:
Sep 2024
Sep 2024
Historique:
revised:
19
07
2024
received:
13
12
2023
accepted:
16
08
2024
medline:
3
9
2024
pubmed:
3
9
2024
entrez:
3
9
2024
Statut:
ppublish
Résumé
Long-term use of hydrochlorothiazide increases the risk of non-melanoma skin cancer. We aimed to evaluate potential changes in the use of hydrochlorothiazide in Switzerland after a direct healthcare professional communication (DHPC) in November 2018 by Swissmedic. We performed interrupted time-series analyses using a large Swiss healthcare claims database (2015-2021). Within monthly intervals, we quantified the total number of claims and the total dispensed 'defined daily doses' (DDD) for preparations containing (1) hydrochlorothiazide, (2) angiotensin-converting enzyme (ACE) inhibitors and angiotensin-II-receptor blockers (ARB), (3) calcium-channel blockers (CCB) and (4) thiazide-like diuretics per 10 000 persons. Using segmented linear regression, we quantified the pre-DHPC trend, the immediate change and the post-DHPC change in trend for total claims and DDD for the four drug classes weighted for the demographic distribution of the Swiss population. ACE inhibitors and ARB were the most frequently claimed antihypertensive drugs with 300-400 claims per 10 000 persons, which increased by 5.4% during the study period. The average number of hydrochlorothiazide claims (157/10 000 persons in 2015) declined by 35% between 2015 and 2021. The decrease started prior to the DHPC, but the DHPC was associated with an immediate 6.1% decline and an accelerated decline in claims over time after the DHPC (similar results for DDD). This coincided with a 23% increase in claims of CCB (dihydropyridine type) over 7 years, whereas use of other antihypertensives increased less. Our results suggest that the DHPC by Swissmedic in 2018 accelerated a pre-existing decline in the use of hydrochlorothiazide in Switzerland.
Substances chimiques
Hydrochlorothiazide
0J48LPH2TH
Antihypertensive Agents
0
Angiotensin-Converting Enzyme Inhibitors
0
Angiotensin Receptor Antagonists
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e70005Subventions
Organisme : Basel Pharmacoepidemiology Unit (BPU)
Informations de copyright
© 2024 The Author(s). Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.
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