Nordic Prescription Registers in Iceland: Overview and Coverage
The Nordic Prescription Registers in Iceland provide detailed data on prescription drug dispensing, covering variables such as drug user information, dispensing details, prescriber data, pharmacy information, and more. The database includes information on all reimbursed and non-reimbursed prescription drugs dispensed to the outpatient population since January 1st, 2003. However, drug indications and dosing instructions are not included in the database. The coverage encompasses drugs dispensed over the counter, outpatient populations, and dispensings within hospitals and nursing facilities. Apart from prescription data, Iceland also maintains registers for hospitalizations, residency, birth records, cancer, heart disease, and causes of death, providing comprehensive healthcare insights.
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Nordic Prescription Registers Iceland Helga Zo ga Epidemiology Mount Sinai School of Medicine (University of Iceland)
Essential Demographics Size of population 318,452 as of January 1st2011 Detailed public statistics available at http://www.statice.is/
Relevant Host Institution The Icelandic Directorate of Health [Landl knisemb tti ] www.landlaeknir.is Department of Health Statistics
Prescription Variables - what is covered (I)? Data on all reimbursed and non-reimbursed prescription drugs dispensed to the outpatient population from January 1st2003. Similar variables included as in the other Nordic prescription registers.
Prescription Variables - what is covered (II)? Drug User Variables Dispensing Variables Prescriber Variables Pharmacy Variables Personal id no. (encrypted) Location and name of dispensing pharmacy Date of dispensing Specialty of prescriber Age at dispensing date (and at end of year) Prescriber practice code (encrypted) Date of prescribing Sex Product code (Nordic article number Region of residence Product name ATC-code Dose unit, DDDs Number of dose units in package No. of prescription fills Reimbursement type, and whether or not reimbursed Reference price
Prescription Variables - what is not included? Prescribed drug indications. Dosing instructions.
Coverage of Prescription Database What is covered? What is not covered? Drugs dispensed over the counter (OTC, non- prescriptions). Prescription drug dispensing to total outpatient population. Idependent of income. Dispensings within hospitals and nursing facilities. All dispensed prescription drugs. Some mechanical dose dispensings before January 1st 2006. Reimbursed and non- reimbursed drug prescriptions.
Available Data on Hospitalisation and Other Variables In-Patient Registry Data on hospitalizations available from 1999. Other relevent registers? National Population Registry (residency, migration, birthdate, marital satus, etc.) Medical Birth Register (1981) Cancer Registry (1955) Monica Heart Disease Register (1981, selected pop.) Cause of Death Registry (1911/1950) Database on Standardized Scholastic Testing for Children (1990 s)
Procedures for Linkage Ethical approvals needed from National Bioethics Committee Data Protection Authority Directorate of Health (pre-approval statement) Institution holding relevant linkage data (pre-approval statement) In most cases linkage, decryption and re-encryption will take place at the Directorate of Health according to procedures specified by the Data Protection Authority.
Practicalitities Whom to approach Directorate of Health www.landlaeknir.is Regarding access to Icelandic Medicines Registry and most other health registers. Ethical Approvals: Yes, many! National Bioethics Committee www.visindasidanefnd.is Data Protection Authority www.personuvernd.is Relevant data hosting institute (Directorate of Health, Cancer Institute, Statistics Iceland, etc.) www.landlaeknir.is Can data be transferred? Yes, with all required ethical approvals and according to procedures specified by the Data Protection Authority. Costs Until now payment has not been required but may change. Time A few months normally
Examples of Papers Zo ga H, Rothman KJ, HuybrechtsKF, lafsson , Baldursson G, Almarsd ttir AB,J nsd ttir S, Halld rsson M,Hern ndez-Diaz S, Valdimarsd ttir UA. Stimulant Drug Treatment for ADHD and Academic Progress in Children. Submitted, Sep 2011. Carlsen HK, Zo ga H, Valdimarsd ttir U, Gislason Th, Hrafnkelsson B. Hydrogen sulfide and particle matter levels associated with increased dispensing of anti-asthma drugs in Iceland's capital. Submitted, Sep 2011. Zo ga H, Furu K, Halld rsson M, Thomsen PH, Sourander A, Martikainen JE. Use of ADHD drugs in the Nordic countries: a population-based comparison study. Acta Psychiatr Scand. 2011 May;123(5):360-7. doi: 10.1111/j.1600-0447.2010.01607.x. Epub 2010 Sep 23. Gudbjornsson B, Thorsteinsson SB, Sigvaldason H, Einarsdottir R, Johannsson M, Zoega H, Halldorsson M, Thorgeirsson G. Rofecoxib, but not celecoxib, increases the risk of thromboembolic cardiovascular events in young adults-a nationwide registry-based study. Eur J Clin Pharmacol. 2010 Jun;66(6):619-25. Epub 2010 Feb 16. Zo ga H, Baldursson G, Hrafnkelsson B, Almarsd ttir AB, Valdimarsd ttir U, Halld rsson M. Psychotropic drug use among Icelandic children: a nationwide population-based study. J Child Adolesc Psychopharmacol. 2009 Dec;19(6):757-64. Samuelsson O, Zoega H, Gudmundsson A, Halldorsson M. [Prevalence of psychotropic drug use among elderly Icelanders living at home].Laeknabladid. 2009 Jan;95(1):11-7. Icelandic. Zo ga H, Baldursson G, Halld rsson M.[Use of methylphenidate among children in Iceland 1989- 2006]. Laeknabladid. 2007 Dec;93(12):825-32. Icelandic.
