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1.  From prescriptions to drug use periods - things to notice 
BMC Research Notes  2014;7(1):796.
Background
Electronic prescription registers provide a vast data source for pharmacoepidemiological research. Prescriptions as such are not suitable for all research purposes; e.g., studying concurrent use of different drugs or adverse drug events during current use. For those purposes, data on dispensed prescriptions needs to be transformed to periods of drug use.
Methods
We used 3,828,292 dispensed prescriptions claimed between 1 January 2002 and 31 December 2009 for 28,093 persons with Alzheimer’s disease. Examples of drug use histories are presented to discuss different aspects that should be noticed when using register-based data consisting of drug purchases.
Results
There is no simple method for correctly transforming dispensed prescriptions to periods of drug use that is usable for all drugs and drug users. Fixed assumptions of daily dose (in defined daily doses, tablets or other units) and fixed time windows should be used with caution and adjusted for different drug use patterns.
Conclusions
We recommend that when transforming prescription drug purchases to drug use periods personal dose, purchasing pattern and other behavioral differences between patients should be taken into account.
doi:10.1186/1756-0500-7-796
PMCID: PMC4239374  PMID: 25398553
Prescription register; Modeling; Drug utilization; Pharmacoepidemiology
2.  Price, familiarity, and availability determine the choice of drug - a population-based survey five years after generic substitution was introduced in Finland 
Background
Mandatory generic substitution (GS) was introduced in Finland at the beginning of April 2003. However, individual patients or physicians may forbid the substitution. GS was a significant change for Finnish medicine users. It was thought it would confuse people when the names, colors, packages, etc., changed. The purpose of this study was to explore what medicine-related factors influence people's choice of prescription drugs five years after generic substitution was introduced in Finland.
Methods
A population survey was carried out during the autumn of 2008. A random sample was drawn from five mainland counties. A questionnaire was mailed to 3000 people at least 18 years old and living in Finland. The questionnaire consisted of both structured and open-ended questions. Factors that influenced the subjects' choice of medicines were asked with a structured question containing 11 propositions. Descriptive statistical analyses were performed.
Results
In total, 1844 questionnaires were returned (response rate, 62%). The percentage of female respondents was 55%. Price, availability, and familiarity were the three most important factors that influenced the choice of medicines. For the people who had refused GS, the familiarity of the medicine was the most important factor. For the subjects who had allowed GS and for those who had both refused and allowed GS, price was the most important factor.
Conclusions
The present study shows that price, familiarity, and availability were important factors in the choice of prescription medicines. The external characteristics of the medicines, for instance the color and shape of the tablet/capsule or the appearance of the package, were not significant characteristics for people.
doi:10.1186/1472-6904-11-20
PMCID: PMC3262749  PMID: 22171800
3.  The use of complementary and alternative medicine products in preceding two days among Finnish parents - a population survey 
Background
The use of complementary and alternative medicines (CAM) has been extensively studied globally among adult and paediatric populations. Parents, as a group, had not been studied to assess their knowledge and attitude to CAM and general medicine use. This study is necessary since parents' attitude to medicine use is known to influence their child's attitude to medicine use later in life. We therefore aim to assess the extent and types of CAM use among Finnish parents, and to determine the factors that promote the CAM use. Also, we aim to determine parents' attitude to general medicine use.
Methods
Children less than 12 years old, as of spring 2007, were identified from the database of the Finnish Population Register Centre and were selected by random sampling. The parents of these children were identified and a questionnaire was sent to them. Only the parent who regularly takes care of the child's medicine was requested to fill the questionnaire. Cross-tabulations and Chi-square test were used to determine the associations between categorical variables. CAMs were defined as natural products that are not registered as medicines, such as homeopathic preparations, dietary food supplements, and traditional medicinal products.
Results
The response rate of the survey was 67% (n = 4032). The use of CAM was 31% in the preceding two days. The most commonly used CAM products were vitamins and minerals, followed by fish oils and fatty acids. Prescription and OTC medicines were used concomitantly with CAM by one-third of the parents. CAM was frequently used by parents over 30 years (33%), female parents (32%), highly educated parents (35%), and parents with high monthly net income (3000-3999 euros, 34%). The users of CAM had more negative attitudes towards medicines than non-users of CAM.
Conclusions
Our findings are in accordance with those of previous studies that women over 30 years of age with a high education and income typically use CAMs. Finnish parents seem to use CAMs as complementary rather than alternative to medicines. Health care professionals should take into consideration both the concomitant use as well as the negative attitudes among CAM users in encounters with the parents.
doi:10.1186/1472-6882-11-107
PMCID: PMC3234193  PMID: 22053865
4.  Children's health and parental socioeconomic factors: a population-based survey in Finland 
BMC Public Health  2011;11:457.
Background
Socioeconomic inequalities in health are a global problem, not only among the adult population but also among children. However, studies concerning young children especially are rare. The aim of this study was to describe the health of Finnish children under 12 years of age, and the socioeconomic factors associated with health. The socioeconomic factors were parental education level, household net income, and working status.
Methods
A population-based survey among Finnish children aged under 12 years (n = 6,000) was conducted in spring 2007. A questionnaire was sent to parents, and a response rate of 67% was achieved. Each child's health was explored by asking a parent to report the child's health status on a 5-point Likert scale, current symptoms from a symptoms list, and current disease(s) diagnosed by a physician. The final three outcome measures were poor health, the prevalences of psychosomatic symptoms, and long-term diseases. Data were analysed using Pearson's Chi-Square tests, and logistic regression analysis with 95% confidence intervals (CIs). P-values ≤0.05 were considered as statistically significant.
Results
In total, 3% of parents reported that their child's health status was poor. The prevalences of psychosomatic symptoms and long-term diseases were both 11%. The probability for poor health status was lowest among children aged 3-6 and 7-11 years, and for psychosomatic symptoms among 3-6-year-old children, whereas the odds ratios for long-term diseases was highest among children aged 7-11 years. Parental socioeconomic factors were not associated with the children's health.
Conclusions
Most of the children were reported by their parent to have good health status, and approximately one tenth had experienced some psychosomatic symptoms or long-term diseases. Our study suggests that parental socioeconomic factors are not associated with the health of children aged under 12 years in Finland.
doi:10.1186/1471-2458-11-457
PMCID: PMC3135536  PMID: 21658272
child; health; socioeconomic factors; population-based study
5.  The impact of generic substitution on the activities of pharmaceutical companies - a survey from the companies' perspective one year and five years after the introduction of generic substitution in finland 
Background
Mandatory generic substitution (GS) was introduced in Finland on 1 April 2003. The aim of this study was to explore and compare the impacts of GS on the activities of pharmaceutical companies representing mainly original or generic pharmaceutical products in Finland. The self-reported impact of GS from pharmaceutical companies' perspective was explored with a focus on the number of employees, the range of sales packages on the market, the marketing activities, the research and development of new pharmaceutical products and storage of pharmaceuticals.
Methods
A cross-sectional postal survey was conducted among pharmaceutical companies with an office in Finland and substitutable medicines in the Finnish pharmaceutical market one year (2004) and five years (2008) after the introduction of GS. Completed questionnaires were returned by 16 original and 7 generic product companies in 2004 (response rate 56%, n = 41) and by 16 original and 6 generic product companies in 2008 (response rate 56%, n = 39). Descriptive statistical analyses were performed.
Results
The number of employees (2004: n = 6/16, 2008: n = 7/16) and the amount of prescription medicine marketing (2004: n = 7/16, 2008: n = 8/16) decreased in many of the original product companies after the introduction of GS. GS resulted in problems related to the storage of pharmaceuticals in the original product companies shortly after GS was introduced (p = 0.032 between 2004 and 2008). In the generic product companies, the prescription medicine representatives' visits to pharmacies increased at the beginning of GS (p = 0.021 between 2004 and 2008). In addition, GS caused problems with the storage of pharmaceuticals one year and five years after the reform (2004: n = 4/7, 2008: n = 3/6). The differences between original and generic product companies regarding the impacts of GS were not, however, statistically significant. GS did not affect on the range of sales packages on the market or the research activities of the majority of companies.
Conclusions
The study suggests that GS has had impacts on the activities of pharmaceutical companies in Finland. There were also some differences, although not statistically significant, between the surveyed original and generic product companies regarding the self-reported impacts of GS. More investigations are needed in this field.
doi:10.1186/1472-6904-10-15
PMCID: PMC2974660  PMID: 20964869

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