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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
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Medicina 2017, 53(4), 259-267; https://doi.org/10.1016/j.medici.2017.07.004 (registering DOI)

Utilization of cardiovascular medicines and cardiovascular mortality in Lithuania, Sweden and Norway in 2003–2012

1
Department of Pathology, Forensic Medicine and Pharmacology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
2
The Ministry of Health, Vilnius, Lithuania
3
State Medicines Control Agency under the Ministry of Health, Vilnius, Lithuania
*
Author to whom correspondence should be addressed.
Received: 3 March 2017 / Revised: 6 June 2017 / Accepted: 3 July 2017 / Published: 31 July 2017
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Abstract

Objective: The aim of this ecological study was to evaluate whether any changes in cardio-vascular (CV) medicine utilization, population, socioeconomic and health system factors were associated with CV mortality in Lithuania, Sweden and Norway in 2003–2012.
Materials and methods: CV drug utilization was calculated using the Anatomical Therapeutic Chemical/Defined Daily Dose (DDD) methodology and expressed as a number of DDD per 1000 inhabitants per day (DDD/TID). The CV age-standardized death rate (CV-SDR) and risk factors data were obtained from the WHO, EUROSTAT, and FAOSTAT databases. The multiple linear regression model was used for modeling outcome measures - the relationship between the CV-SDR and CV medicine utilization including socioeconomic (GDP, unemployment and divorce rate), population (alcohol consumption, smoking and amount of kcal per day, consumption of fruit and vegetables, health status self-evaluation) and health system factors (number of hospital beds, practicing physicians and health care expenditure).
Results: The higher CV medicine utilization in Sweden (307–455 DDD/TID, P < 0.001) and Norway (306–394 DDD/TID, P < 0.001) was associated with a definite decline in CV-SDR (in Norway from 215 to 146 and in Sweden from 233 to 174). In Lithuania, the increasing but lower consumption of CV medicines (135–360 DDD/TID, P < 0.001) and twice higher CV-SDR (from 541 to 447) was registered. A significant inverse correlation was observed between CVSDR and DDD/TID. We found a strong association between the DDD/TID and the CV-SDR (R2 = 0.67, P < 0.001). There was a strong correlation between CV-SDR and nine factors (P < 0.05), except the number of practicing physicians, amount of kcal per day. There was a strong correlation between DDD/TID and nine factors (P < 0.05), except the unemployment rate and amount of kcal per day. Association between an increase in the use of medicines and a decrease in CV-SDR was stronger in the case of higher alcohol consumption, higher number of available beds in hospitals and the lower unemployment rate.
Conclusions: We confirmed the strong negative correlation between CV medicine utilization and CV mortality in all countries. The strong correlation was found between CV-SDR and nine factors, also between the use of CV medicines and nine factors. The impact of factors on the medicines induced decrease in CV-SDR showed the stronger influence in case of lower unemployment, higher alcohol consumption and higher number of beds for hospitalization. View Full-Text
Keywords: Cardiovascular disease; Medicine utilization; Risk factors; Mortality Cardiovascular disease; Medicine utilization; Risk factors; Mortality
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Lisauskienė, I.; Garuolienė, K.; Gulbinovič, J. Utilization of cardiovascular medicines and cardiovascular mortality in Lithuania, Sweden and Norway in 2003–2012. Medicina 2017, 53, 259-267.

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