Department of Public Health and Primary Care, University of Leuven (KU Leuven), Leuven, Belgium.
Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium.
Eur J Public Health. 2018 Feb 1;28(1):193-198. doi: 10.1093/eurpub/ckx106.
Various methods exist to estimate disease prevalences. The aim of this study was to determine whether dispensed, self-reported and prescribed medication data could be used to estimate the prevalence of diabetes mellitus and thyroid disorders. Second, these pharmaco-epidemiological estimates were compared with prevalences based on self-reported diagnoses and doctor-registered diagnoses.
Data on medication for diabetes and thyroid disorders were obtained from three different sources in Flanders (Belgium) for 2008: a purely administrative database containing data on dispensed medication, the Belgian National Health Interview Survey for self-reported medication and diagnoses, and a patient record database for prescribed medication and doctor-registered diagnoses. Prevalences were estimated based on medication data and compared with each other. Cross-tabulations of dispensed medication and self-reported diagnoses, and prescribed medication and doctor-registered diagnoses, were investigated.
Prevalences based on dispensed medication were the highest (4.39 and 2.98% for diabetes and thyroid disorders, respectively). The lowest prevalences were found using prescribed medication (2.39 and 1.72%, respectively). Cross-tabulating dispensed medication and self-reported diagnoses yielded a moderate to high sensitivity for diabetes (90.4%) and thyroid disorders (77.5%), while prescribed medication showed a low sensitivity for doctor-registered diagnoses (56.5 and 43.6%, respectively). The specificity remained above 99% in all cases.
This study was the first to perform cross-tabulations for disease prevalence estimates between different databases and within (sub)populations. Purely administrative database was shown to be a reliable source to estimate disease prevalence based on dispensed medication. Prevalence estimates based on prescribed or self-reported medication were shown to have important limitations.
有多种方法可以估计疾病的患病率。本研究旨在确定配药、自我报告和处方药物数据是否可用于估计糖尿病和甲状腺疾病的患病率。其次，将这些药物流行病学估计值与基于自我报告的诊断和医生登记的诊断的患病率进行比较。
2008 年，我们从比利时佛兰德斯的三个不同来源获得了有关糖尿病和甲状腺疾病药物的数据：一个纯粹的行政数据库，包含配药数据；比利时国家健康访谈调查，用于自我报告药物和诊断；以及一个患者记录数据库，用于处方药物和医生登记的诊断。基于药物数据估计患病率，并相互比较。对配药和自我报告的诊断，以及处方药物和医生登记的诊断进行交叉制表。
基于配药的患病率最高（分别为糖尿病和甲状腺疾病的 4.39%和 2.98%）。使用处方药物发现的患病率最低（分别为 2.39%和 1.72%）。配药与自我报告的诊断交叉制表对糖尿病（90.4%）和甲状腺疾病（77.5%）具有中等至高的敏感性，而处方药物对医生登记的诊断的敏感性较低（分别为 56.5%和 43.6%）。在所有情况下，特异性均保持在 99%以上。
本研究首次在不同数据库之间以及（亚）人群内进行了疾病患病率估计的交叉制表。纯行政数据库被证明是基于配药来估计疾病患病率的可靠来源。基于处方或自我报告的药物的患病率估计存在重要局限性。
