The use of GP databases in comparative research: the case of diabetes care in Sweden and the Netherlands.

Background: Sweden and the Netherlands have, compared to many other European countries, low levels of drug utilization. However, are they still, more alike when prescription patterns are compared in more detail? GP databases provide such an opportunity because they provide information on both clinical diagnoses and prescriptions. Prevalence of diabetes increases in both countries, as does the role of primary care in diabetes management. In this presentation we focus on diabetes care in Sweden and the Netherlands for patients with and without co-morbidity using primary care databases. Methods: Data from 2005 are derived for Sweden from the Skaraborg Primary Care Research Database (SPCRD), which includes 24 primary health care centres in southwestern Sweden. Dutch data are derived from the Netherlands Information Network of General Practice (LINH), including 80 general practices. Both databases provide patient and GP level data on clinical diagnoses and pharmaceutical treatment. Data are analyzed using multilevel analyses in order to take the nested structure of the data into account. Results: Differences and similarities in treatment guidelines between the two countries will be presented together with a description of drug utilization and of how well treatment goals are met in respective country. Included are 10 000 Swedish and 9000 Dutch patients. Preliminary analyses showed that in Sweden diabetes is more often treated with insulin than the Netherlands. In both countries women are less liable to receive lipid-lowering drugs, while in the Netherlands women are more liable to receive antihypertensives. The final results will focus on treatment accounting for co-morbidity. Conclusions: The use of primary care databases enables us to compare treatment of diabetes in different countries in more detail than if only pharmacy or claim data are available. Sweden and the Netherlands show differences in diabetes treatment, which need to be explored in more detail. (aut. ref.