@article{RN321,
   author = {Hendriksen, L. C. and Verhamme, K. M. C. and Van der Linden, P. D. and Stricker, B. H. and Visser, L. E.},
   title = {Women are started on a lower daily dose of metoprolol than men irrespective of dose recommendations: A potential source of confounding by contraindication in pharmacoepidemiology},
   journal = {Pharmacoepidemiol Drug Saf},
   volume = {30},
   number = {7},
   pages = {952-959},
   note = {1099-1557 Hendriksen, Linda C Orcid: 0000-0003-0534-4841 Verhamme, Katia M C Van der Linden, Paul D Stricker, Bruno H Visser, Loes E Journal Article Research Support, Non-U.S. Gov't England 2021/03/07 Pharmacoepidemiol Drug Saf. 2021 Jul;30(7):952-959. doi: 10.1002/pds.5220. Epub 2021 Mar 29.},
   abstract = {PURPOSE: Current guidelines have no sex-specific dosage advice for metoprolol. To evaluate whether women and men are prescribed the same dose a cohort analysis was performed in the population-based Rotterdam Study (RS). Results were replicated in the Integrated Primary Care Information (IPCI) database of automated general practice data. METHODS: The mean daily starting doses of metoprolol in both sexes were compared with independent-samples t-tests and a linear regression analysis was used to adjust in the RS for co-variables, notably, cardiovascular comorbidity, migraine, age, SBP, DBP, BMI, socioeconomic status, use of other antihypertensive drugs, smoking, and alcohol. In the IPCI-database, adjustment was for age only. RESULTS: The mean daily starting dose was statistically significantly lower in women than in men in both the RS and IPCI database, with a mean difference of 4.8 mg (95%CI -7.8, -1.8) and 4.6 mg (95%CI -5.3,-4.0), respectively. Statistical significance remained after adjustment in both databases. CONCLUSIONS: Women received lower starting doses of metoprolol than men in two independent data collections despite non-sex specific cardiovascular guideline recommendations. This example of real-life pharmacotherapy can lead to a form of confounding by contraindication in pharmacoepidemiology.},
   keywords = {Antihypertensive Agents
Cohort Studies
Contraindications
Female
Humans
Male
*Metoprolol
*Pharmacoepidemiology
Pharmacoepidemiology
drug utilization
evidence-based medicine
prescribing ,
ISSN = 1053-8569 (Print) 1053-8569 ,
DOI = 10.1002/pds.5220},
   year = {2021},
   type = {Journal Article}
}

{"_id":"zmGbP5hpAJFMiCRNS","bibbaseid":"hendriksen-verhamme-vanderlinden-stricker-visser-womenarestartedonalowerdailydoseofmetoprololthanmenirrespectiveofdoserecommendationsapotentialsourceofconfoundingbycontraindicationinpharmacoepidemiology-2021","author_short":["Hendriksen, L. C.","Verhamme, K. M. C.","Van der Linden, P. D.","Stricker, B. H.","Visser, L. E."],"bibdata":{"bibtype":"article","type":"Journal Article","author":[{"propositions":[],"lastnames":["Hendriksen"],"firstnames":["L.","C."],"suffixes":[]},{"propositions":[],"lastnames":["Verhamme"],"firstnames":["K.","M.","C."],"suffixes":[]},{"propositions":["Van","der"],"lastnames":["Linden"],"firstnames":["P.","D."],"suffixes":[]},{"propositions":[],"lastnames":["Stricker"],"firstnames":["B.","H."],"suffixes":[]},{"propositions":[],"lastnames":["Visser"],"firstnames":["L.","E."],"suffixes":[]}],"title":"Women are started on a lower daily dose of metoprolol than men irrespective of dose recommendations: A potential source of confounding by contraindication in pharmacoepidemiology","journal":"Pharmacoepidemiol Drug Saf","volume":"30","number":"7","pages":"952-959","note":"1099-1557 Hendriksen, Linda C Orcid: 0000-0003-0534-4841 Verhamme, Katia M C Van der Linden, Paul D Stricker, Bruno H Visser, Loes E Journal Article Research Support, Non-U.S. Gov't England 2021/03/07 Pharmacoepidemiol Drug Saf. 2021 Jul;30(7):952-959. doi: 10.1002/pds.5220. Epub 2021 Mar 29.","abstract":"PURPOSE: Current guidelines have no sex-specific dosage advice for metoprolol. To evaluate whether women and men are prescribed the same dose a cohort analysis was performed in the population-based Rotterdam Study (RS). Results were replicated in the Integrated Primary Care Information (IPCI) database of automated general practice data. METHODS: The mean daily starting doses of metoprolol in both sexes were compared with independent-samples t-tests and a linear regression analysis was used to adjust in the RS for co-variables, notably, cardiovascular comorbidity, migraine, age, SBP, DBP, BMI, socioeconomic status, use of other antihypertensive drugs, smoking, and alcohol. In the IPCI-database, adjustment was for age only. RESULTS: The mean daily starting dose was statistically significantly lower in women than in men in both the RS and IPCI database, with a mean difference of 4.8 mg (95%CI -7.8, -1.8) and 4.6 mg (95%CI -5.3,-4.0), respectively. Statistical significance remained after adjustment in both databases. CONCLUSIONS: Women received lower starting doses of metoprolol than men in two independent data collections despite non-sex specific cardiovascular guideline recommendations. This example of real-life pharmacotherapy can lead to a form of confounding by contraindication in pharmacoepidemiology.","keywords":"Antihypertensive Agents Cohort Studies Contraindications Female Humans Male *Metoprolol *Pharmacoepidemiology Pharmacoepidemiology drug utilization evidence-based medicine prescribing , ISSN = 1053-8569 (Print) 1053-8569 , DOI = 10.1002/pds.5220","year":"2021","bibtex":"@article{RN321,\r\n author = {Hendriksen, L. C. and Verhamme, K. M. C. and Van der Linden, P. D. and Stricker, B. H. and Visser, L. E.},\r\n title = {Women are started on a lower daily dose of metoprolol than men irrespective of dose recommendations: A potential source of confounding by contraindication in pharmacoepidemiology},\r\n journal = {Pharmacoepidemiol Drug Saf},\r\n volume = {30},\r\n number = {7},\r\n pages = {952-959},\r\n note = {1099-1557 Hendriksen, Linda C Orcid: 0000-0003-0534-4841 Verhamme, Katia M C Van der Linden, Paul D Stricker, Bruno H Visser, Loes E Journal Article Research Support, Non-U.S. Gov't England 2021/03/07 Pharmacoepidemiol Drug Saf. 2021 Jul;30(7):952-959. doi: 10.1002/pds.5220. Epub 2021 Mar 29.},\r\n abstract = {PURPOSE: Current guidelines have no sex-specific dosage advice for metoprolol. To evaluate whether women and men are prescribed the same dose a cohort analysis was performed in the population-based Rotterdam Study (RS). Results were replicated in the Integrated Primary Care Information (IPCI) database of automated general practice data. METHODS: The mean daily starting doses of metoprolol in both sexes were compared with independent-samples t-tests and a linear regression analysis was used to adjust in the RS for co-variables, notably, cardiovascular comorbidity, migraine, age, SBP, DBP, BMI, socioeconomic status, use of other antihypertensive drugs, smoking, and alcohol. In the IPCI-database, adjustment was for age only. RESULTS: The mean daily starting dose was statistically significantly lower in women than in men in both the RS and IPCI database, with a mean difference of 4.8 mg (95%CI -7.8, -1.8) and 4.6 mg (95%CI -5.3,-4.0), respectively. Statistical significance remained after adjustment in both databases. CONCLUSIONS: Women received lower starting doses of metoprolol than men in two independent data collections despite non-sex specific cardiovascular guideline recommendations. This example of real-life pharmacotherapy can lead to a form of confounding by contraindication in pharmacoepidemiology.},\r\n keywords = {Antihypertensive Agents\r\nCohort Studies\r\nContraindications\r\nFemale\r\nHumans\r\nMale\r\n*Metoprolol\r\n*Pharmacoepidemiology\r\nPharmacoepidemiology\r\ndrug utilization\r\nevidence-based medicine\r\nprescribing ,\r\nISSN = 1053-8569 (Print) 1053-8569 ,\r\nDOI = 10.1002/pds.5220},\r\n year = {2021},\r\n type = {Journal Article}\r\n}\r\n\r\n","author_short":["Hendriksen, L. C.","Verhamme, K. M. C.","Van der Linden, P. D.","Stricker, B. H.","Visser, L. E."],"key":"RN321","id":"RN321","bibbaseid":"hendriksen-verhamme-vanderlinden-stricker-visser-womenarestartedonalowerdailydoseofmetoprololthanmenirrespectiveofdoserecommendationsapotentialsourceofconfoundingbycontraindicationinpharmacoepidemiology-2021","role":"author","urls":{},"keyword":["Antihypertensive Agents Cohort Studies Contraindications Female Humans Male *Metoprolol *Pharmacoepidemiology Pharmacoepidemiology drug utilization evidence-based medicine prescribing","ISSN = 1053-8569 (Print) 1053-8569","DOI = 10.1002/pds.5220"],"metadata":{"authorlinks":{}},"html":""},"bibtype":"article","biburl":"https://bibbase.org/network/files/qwipow2DJsAxqNp83","dataSources":["PJSqX8FMpCPRdw3CQ","qLDnCcKM9omXNrRY8","TB9sD3avjy7bNxfgS","vDmJPYmHEKAT3tMNL","PcZMFHooKwpboi2he","jZMXEeHTfokmisJDv"],"keywords":["antihypertensive agents cohort studies contraindications female humans male *metoprolol *pharmacoepidemiology pharmacoepidemiology drug utilization evidence-based medicine prescribing","issn = 1053-8569 (print) 1053-8569","doi = 10.1002/pds.5220"],"search_terms":["women","started","lower","daily","dose","metoprolol","men","irrespective","dose","recommendations","potential","source","confounding","contraindication","pharmacoepidemiology","hendriksen","verhamme","van der linden","stricker","visser"],"title":"Women are started on a lower daily dose of metoprolol than men irrespective of dose recommendations: A potential source of confounding by contraindication in pharmacoepidemiology","year":2021}