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Showing papers by "Saskatchewan Health published in 1992"


Journal ArticleDOI
23 Dec 1992-JAMA
TL;DR: Data support recent guidelines from several countries that recommend the use of inhaled corticosteroids in moderate and severe asthma.
Abstract: Objective. —To examine the relationship between patterns of use of inhaled beclomethasone dipropionate and the risk of fatal and near-fatal asthma. Design. —Nested case-control analysis of a historical cohort; a further analysis. Setting. —The 12 301 residents of Saskatchewan aged 5 to 54 years who were dispensed 10 or more asthma drugs from 1978 to 1987. Patients. —The 129 persons who experienced asthma death (n=44) and near-death (n=85) and their 655 controls matched as to age and date of entry into the cohort, with the additional matching criteria of at least one hospitalization for asthma in the prior 2 years, region of residence, and having received social assistance. Main Outcome. —Life-threatening attacks of asthma defined as death due to asthma or the occurrence of hypercarbia, intubation, and mechanical ventilation during an acute attack of asthma. Results. —After accounting for the risk associated with use of other medications and adjustment for markers of risk of adverse events related to asthma, subjects who had been dispensed, on average, one or more metered-dose inhalers of beclomethasone per month over a 1-year period had a significantly lower risk of fatal and near-fatal asthma (odds ratio, 0.1; 95% confidence interval, 0.02 to 0.6). Conclusion.—These data support recent guidelines from several countries that recommend the use of inhaled corticosteroids in moderate and severe asthma. ( JAMA . 1992;268:3462-3464)

283 citations


Journal Article
TL;DR: The results quantify the prevalence of prescription drug use, underscore the importance of careful management of drug therapy by physicians and pharmacists (especially for seniors), illustrate substantial variation in drug therapy strategies and raise questions about utilization of benzodiazepines and cardiovascular drugs.
Abstract: OBJECTIVE: To measure the prevalence of prescription drug use in Saskatchewan in 1989. DESIGN: Retrospective study. PARTICIPANTS: A total of 961,203 Saskatchewan residents (including those who died or were born during the study year) who were eligible for coverage under the Saskatchewan Prescription Drug Plan. The study population represented 94% of the province9s total population; those excluded were mostly status Indians (for whom a federal plan is available). MAIN RESULTS: At least one prescription was received by 66.0% of the study population in 1989. The mean number of prescriptions per patient was 8.2, and the mean cost of drug material per prescription was $13.95. Females received substantially more prescriptions than males; the difference was particularly notable for cardiovascular agents, antidepressants and benzodiazepines. In the senior population 80.8% received at least one prescription; the mean number of prescriptions per patient was 18.4. The most commonly dispensed drug for the entire study population was amoxicillin (290 prescriptions per 1000 people); triazolam was the most frequently dispensed central nervous system drug (74 prescriptions per 1000 people). Regional variation in overall drug use was remarkably small, although it increased at the drug-class level, especially for tranquillizers. The use of cardiovascular drugs was 27% to 32% higher (depending on how use was measured) per Regina resident than per Saskatoon resident. Benzodiazepines were commonly used on a long-term basis, despite recommendations to the contrary. CONCLUSIONS: The results quantify the prevalence of prescription drug use, underscore the importance of careful management of drug therapy by physicians and pharmacists (especially for seniors), illustrate substantial variation in drug therapy strategies and raise questions about utilization of benzodiazepines and cardiovascular drugs.

47 citations


Journal ArticleDOI
TL;DR: The data from this rapid response pharmacoepidemiological study do not support allegations that treatment with human insulin increases the risk of death, and do not exclude the possibility that human insulin is associated with an elevated risk of fatal or non‐fatal hypoglycaemia.
Abstract: In response to growing concerns surrounding the risks of human insulin, we conducted a 13-year historical cohort study of 4925 insulin users less than 40 years of age. This cohort was formed from the population of Saskatchewan, Canada, from 1978–90, using the computerized databases arising from the universal health insurance plan of this Province of 1.1 million inhabitants. Of 101 deaths, 53 occurred within the defined one-month time window of effect. The cohort resulted in 14,600 person-years of exposure to insulin use. The overall rate of death was 3.6 per 1000 person-years of insulin use (95% CI: 2.7–4.6). This death rate remained stable throughout the 13-year study period and did not increase after 1984, the year of introduction of human insulin in Saskatchewan. We found 46 deaths for animal insulin (4.0/1000/year) and 7 deaths for human insulin (2.3/1000/year). Among the latter 7 deaths, 1 death occurred in the group treated solely with human insulin (1.2/1000/year), and 6 deaths in those who were switched from animal to human insulin (2.8/1000/year). These observed differences are not statistically significant. The data from this rapid response pharmacoepidemiological study, which took 8 months to complete, do not support allegations that treatment with human insulin increases the risk of death. They do not however exclude the possibility that human insulin is associated with an elevated risk of fatal or non-fatal hypoglycaemia.

5 citations