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Factors of importance for discontinuation of thiazides associated with hyponatremia in Sweden: A population‐based register study
Author(s) -
Fahlén Bergh Cecilia,
Toivanen Susanna,
Johnell Kristina,
Calissendorff Jan,
Skov Jakob,
Falhammar Henrik,
Nathanson David,
Lindh Jonatan D.,
Mannheimer Buster
Publication year - 2020
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.4922
Subject(s) - thiazide , medicine , hyponatremia , discontinuation , socioeconomic status , pediatrics , population , logistic regression , diuretic , environmental health
Purpose In a patient with clinically significant hyponatremia without other clear causes, thiazide treatment should be replaced with another drug. Data describing to which extent this is being done are scarce. The aim of this study was to investigate sociodemographic and socioeconomic factors that may be of importance for the withdrawal of thiazide diuretics in patients hospitalized due to hyponatremia. Methods The study population was sampled from a case‐control study investigating individuals hospitalized with a main diagnosis of hyponatremia. For every case, four matched controls were included. In the present study, cases (n = 5204) and controls (n = 7425) that had been dispensed a thiazide diuretic prior to index date were identified and followed onward regarding further dispensations. To investigate the influence of socioeconomic and sociodemographic factors, multiple logistic regression was used. Results The crude prevalence of thiazide withdrawal for cases and controls was 71.9% and 10.8%, respectively. Thiazide diuretics were more often withdrawn in medium‐sized towns (adjusted OR, 1.52; 95% CI, 1.21‐1.90) and rural areas (aOR, 1.81; 95% CI, 1.40‐2.34) compared with metropolitan areas and less so among divorced (aOR, 0.72; 95% CI, 0.53‐0.97). However, education, employment status, income, age, country of birth, and gender did not influence withdrawal of thiazides among patients with hyponatremia. Conclusions Thiazide diuretics were discontinued in almost three out of four patients hospitalized due to hyponatremia. Educational, income, gender, and most other sociodemographic and socioeconomic factors were not associated with withdrawal of thiazides.