O H Klungel

..The aim of our study was to investigate the consequences of undertreatment of hypertension for women and men in terms of stroke occurrence...

..To investigate if patients' perceptions of their diabetes status is related to blood glucose self-monitoring (SMBG) behaviour, independent of self-reported disease severity...

..To review methods that seek to adjust for confounding in observational studies when assessing intended drug effects...

....

..The relative effectiveness of various antihypertensive drugs with regard to the reduction of stroke incidence remains uncertain...

..1-8.4% overestimation). When repeated measurements of blood pressure are not available in a population study for a sample of that same study, it is advisable to use data from another study to correct for WPV...

..We estimated the proportion of strokes occurring among treated hypertensive patients that may be attributable to uncontrolled blood pressure...

..These considerations may also play a role in the sex difference in the choice of calcium antagonists and angiotensin converting enzyme inhibitors and require further investigation...

..The combination of a diuretic and a beta-blocker was associated with a worse lipid profile...

....

..The relative risk reduction that we found was similar to those found in randomized controlled trials...

..To investigate cardiovascular drug use and hospitalizations attributable to type 2 diabetes from 1 year before until 6 years after the start of oral antidiabetic therapy...

..It may be advisable to perform a correction for within-person variability to obtain valid prevalence estimates in surveys that only take one or two measurements of blood pressure...

....

..In cases of extreme hyperlipidaemia, medication use should be reassessed...

..Few studies have made direct comparisons, and little is known about the accuracy of these measures in patients on a multiple-drug regimen...

..95). One technician obtained significantly lower DNA yields. Older age was associated with lower DNA purity. In conclusion, DNA yield from buccal swabs was higher in men and DNA purity was associated with age and the use of diuretics...

....

..However, defined daily doses should not be used to estimate (point) prevalences of drug use because this measure is significantly influenced by prescribed dosage regimens...

..Therefore, the detection and control of hypertension in the Netherlands needs to improve. Several groups of hypertensives were identified that need additional care and attention...

..CONCLUSION: Our results suggest that treatment with fluorquinolones in doses commonly prescribed in routine clinical practice is associated with a reduction in the risk of coronary heart diseases among diabetes mellitus type 2 patients...

..On the basis of our review of 232 trials, we conclude that the interpretation and inference of NI trials are complicated, partly because of the incompleteness of the information...

..We conducted a study in daily clinical practice comparing stented and non-stented patients undergoing coronary angioplasty with abciximab administration. Furthermore, we compare our results with the findings of the EPISTENT trial...

..The authors studied whether statin use was associated with an increased risk of developing RA by conducting a case-control study using the Netherlands Information Network of General Practice database...

..Conclusion: Cluster analysis of INR patterns improved the prediction of clinical outcomes over TTR and may help to identify warfarin users who need additional anticoagulation monitoring...

..8 % and 8.2 %. During the next phase of the IMI-PROTECT study, a comparison with individual patient data will show whether this approach is valid...

..To use the population attributable risk (PAR) to estimate the treatment costs resulting from nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal (GI) morbidity...

..ACE-inhibitor users with at least one copy of the 235T-allele of the AGT gene might have an increased risk of MI and stroke...

..The objectives of the current study were to characterize the effect of the hepatic lipase variant, and its interaction with the CETP variant, in terms of cholesterol levels, atherosclerosis, and risk of myocardial infarction (MI)...

..04 mm, P = 0.02). We found that among type 2 diabetic patients, mean systolic blood pressure, pulse pressure, and risk of hypertension increased with the number of risk genotypes for the RAS genes and the salt sensitivity genes...

..To assess patterns of restarting antihypertensive drugs after a prolonged period of discontinuation...

....

..To investigate the 'real world' effectiveness of robust statin therapy, focusing on the effect of dose and early treatment discontinuation on the risk of hospitalization for acute myocardial infarction (AMI)...

..CONCLUSION: Reallocation of resources used for statin therapy from those receiving non-guidelines-indicated treatment to those being undertreated could lead to a more efficient use of resources...

..Both methods are valuable tools in the development of evidence-based pharmacotherapy...

..33 mmHg (95% CI:-9.66 to 5.01). The G460W polymorphism and the M235T polymorphism did not modify the difference in blood pressure levels among subjects who used diuretics, beta-blockers, calcium antagonists, or ACE inhibitors...

..This suggests that implementing practice guidelines for diabetes care in community pharmacy requires different approaches in different regions...

..To determine if the association between the level of community pharmacy diabetes services and six of its reported determinants is influenced by the definition of these services...

..Therefore, we assessed whether the effectiveness of statins in reducing the risk of MI was modified by the GNB3 C825T polymorphism...

..From literature reviews it has been concluded that treatment effect estimates from both methods are quite similar. With this study we will show that there are systematic differences which can be substantial...

..The present study investigates the relationship between persistence with antihypertensive drugs (AHT) and blood pressure (BP) goal attainment in daily clinical practice...

..We have carried out a nested case-control study among diabetic patients to assess the risk of hypoglycaemia requiring hospitalisation associated with the use of antidepressants...

....

..The aim of this study was to describe and compare patterns of use of antihypertensive drugs in a population of elderly patients in the United States (Pennsylvania), Canada (British Columbia) and the Netherlands...

..The present study investigates the effect of early treatment discontinuation with antihypertensive drugs on the risk of acute myocardial infarction (AMI) or stroke in daily clinical practice...

..Future studies with adequate sample sizes in which several SNPs in multiple candidate genes are genotyped in patients with diabetes should provide reliable information on genetic variants and response to glucose-lowering drugs...

..To compare adjusted effects of drug treatment for hypertension on the risk of stroke from propensity score (PS) methods with a multivariable Cox proportional hazards (Cox PH) regression in an observational study with censored data...

..To assess the potential annual savings due to generic and therapeutic substitution of statin therapy for the general Dutch population, taking the patients medical history into account...

..The effect of the cholesteryl ester transfer protein (CETP) I405V polymorphism on lipid levels, atherosclerosis and myocardial infarction (MI) was examined in 6421 participants from the Rotterdam Study...

..To investigate if disturbed glucose homeostasis or known diagnosis of diabetes was associated with depressive symptoms. The reason for the increased prevalence of depression in patients with Type 2 diabetes mellitus (DM2) is unknown...

..As long as existing guidelines are as discrepant as they are now, variation in agreement between physicians' prescribing and guideline recommendations is unavoidable...

..To assess time trends in lipid lowering drug use in The Netherlands...

..Pharmacists and physicians can use pharmacy data, although data tend to overestimate actual compliance, to assess and improve compliance with antihypertensive drugs, before modifying treatment regimens...

..Unfortunately, the quality of these studies is quite variable. Given the methodological problems, the results from the candidate gene studies are still inconclusive and further research is necessary...

..To study the use and effectiveness of lipid-lowering drugs with respect to lowering of cholesterol levels in routine daily practice...

..If other studies confirm that men with the DD genotype do not benefit from treatment with statins, screening for ACE genotype in men most likely will be a cost-effective strategy before initiating statin therapy...

..The objective of this study was to determine the association between different antihypertensive drug therapies and lower extremity amputations (LEAs) in type 2 diabetes patients...

..59-1.39). CONCLUSION: Our results suggest that use of a time-dependent exposure definition is more accurate because estimates of effectiveness were more in agreement with results from randomized controlled trials of statin treatment...

..To assess the proportion of diabetic patients who collect self-monitoring equipment for glucose testing in Dutch community pharmacies...

..Persistence with lipid-lowering drug use is important in order for patients to gain full treatment benefit. The withdrawal of cerivastatin from the market may have affected persistence due to the fear of serious adverse effects...

..18 (CI 1.01-10.03) in men. The apoE genotype is associated with discontinuation of statins. This suggests that subjects who are genetically prone to develop hypercholesterolemia show the highest risk of discontinuation of treatment...

..To assess whether switching to insulin therapy in patients with type 2 diabetes mellitus is associated with medication refill compliance of oral hypoglycemic agents...

..To estimate the number of expected cases of myopathy based on the prevalence of lipid-lowering drug use, and to compare this number with the observed number of cases of myopathy due to lipid-lowering drug use in the Netherlands...

..The protective effect of statins on total mortality was not statistically significant, but did not seem to differ between subjects with different apoE genotypes...

..Determining the genotype will not deny therapy to a subject, but will help in deciding the therapy that will suit the patient best...

..To assess recent trends in undertreatment of hypercholesterolaemia (1998-2002)...

..The pharmacy medication history is a valuable tool for physicians to identify patients who have a high risk on discontinuation with antihypertensive treatment...

..There are some indications that the angiotensin-converting enzyme (ACE) gene modifies the response to antihypertensive drugs, but the results have been inconclusive...

..Results of persistence studies are highly influenced by the researchers' method of the maximum allowed treatment gap...

..However, pharmacists and physicians often find that patients and brand-name manufacturers have doubt about the equivalence of the substituted drug. This may be reflected by decreased adherence to therapy...

..CONCLUSION: Long-term persistence in daily practice is low compared with persistence observed in randomized clinical trials and should be considered in the choice of a first-line antihypertensive agent...

..The objective of the study is to investigate factors related to treatment persistence among users of antihypertensive (AHT) drugs in daily practice...

..CONCLUSIONS: Local collaboration on the division of roles in diabetes care between healthcare professionals is independently associated with the number of pharmacy services provided to patients performing SMBG...

..The aim of this study was to characterize interindividual variation in glucose and lipid responses to hydrochlorothiazide and to identify demographic, environmental, and genetic predictors associated with this variation...

..To assess dosing and determinants of the choice of statins among starters of statins...

..To assess the influence of variations in multiple candidate genes on inter-individual variation in diastolic blood pressure (DBP) response to hydrochlorothiazide...

..40 [95% CI: 1.61-3.60] and 2.55 [95% CI: 1.72-3.78], respectively. CONCLUSION: The variation in cardiovascular medication use could not explain the excess risk of mortality in the rural Serbian cohorts compared to urban Belgrade...

..In general, piggy-back evaluations tended to score higher on quality and may therefore be more valuable in decision making...

..More well-designed and well-conducted studies on the effectiveness of interventions by a community pharmacist to improve patient adherence to chronic medication need to be performed...

..We conclude that instrumental variables can be useful in case of moderate confounding but are less useful when strong confounding exists, because strong instruments cannot be found and assumptions will be easily violated...