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Modelling drug-related morbidity in Sweden using an expert panel of physicians
Nordic School of Public Health NHV, Gothenburg, Sweden.
Nordic School of Public Health NHV, Gothenburg, Sweden.
Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Pharmacology.
Medical Products Agency, Uppsala, Sweden.
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2012 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 68, no 9, 1309-1319 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: In modelling studies using pharmacists' opinions, drug-related morbidity (DRM) and preventable DRM have been more common than in observational studies, and the resulting costs are extensive. Modelling studies' estimates may vary depending on informants' profession. The purpose of this modelling study was to estimate the proportion of patients with DRM and preventable DRM and the cost of illness (COI) of DRM in Sweden based on physicians' expert opinions. METHOD: A conceptual model of DRM was modified from previous studies. Using a modified Delphi technique, a panel of physicians (n = 19) estimated the probabilities of DRM, preventable DRM, and clinical outcomes of DRM separately for outpatients and inpatients. DRM included new medical problems (adverse drug reactions, drug dependence, and intoxications by overdose) and therapeutic failure (insufficient effects of medicines, and morbidity due to untreated indication). A COI analysis included the direct costs of DRM. RESULTS: Physicians estimated that 51 ± 22% [mean ± standard deviation (SD)] of outpatients experience DRM and 12 ± 8% preventable DRM. Of inpatients, 54 ± 17% was estimated to experience DRM and 16 ± 7% preventable DRM. Of outpatients with DRM, 24 ± 11% was estimated to experience preventable DRM, whereas this proportion for inpatients was 31 ± 15%. The estimated COI was 376 euros per outpatient and 838 euros per inpatient. CONCLUSIONS: Swedish physicians estimated that every other outpatient and inpatient experiences DRM, which is often preventable and costly. As physicians' estimates on the proportion of patients with DRM were higher than in observational studies in restricted subpopulations, DRM may be more common in the general population than observational studies suggest.

Place, publisher, year, edition, pages
Springer, 2012. Vol. 68, no 9, 1309-1319 p.
Keyword [en]
Drug-related morbidity, Cost of illness, Preventability, Decision tress, Pharmacoepidemiology
National Category
Pharmacology and Toxicology
URN: urn:nbn:se:liu:diva-76037DOI: 10.1007/s00228-012-1244-3ISI: 000307548400010PubMedID: 22392557OAI: diva2:512264

funding agencies|National Corporation of Swedish Pharmacies (Apoteket AB)||

Available from: 2012-03-27 Created: 2012-03-23 Last updated: 2012-10-18

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Hägg, Staffan
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Clinical PharmacologyFaculty of Health SciencesDepartment of Clinical Pharmacology
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