{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:35:48Z","timestamp":1792697748789,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Long\u2010term use of hydrochlorothiazide increases the risk of non\u2010melanoma skin cancer. We aimed to evaluate potential changes in the use of hydrochlorothiazide in Switzerland after a direct healthcare professional communication (DHPC) in November 2018 by Swissmedic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed interrupted time\u2010series analyses using a large Swiss healthcare claims database (2015\u20132021). Within monthly intervals, we quantified the total number of claims and the total dispensed \u2018defined daily doses\u2019 (DDD) for preparations containing (1) hydrochlorothiazide, (2) angiotensin\u2010converting enzyme (ACE) inhibitors and angiotensin\u2010II\u2010receptor blockers (ARB), (3) calcium\u2010channel blockers (CCB) and (4) thiazide\u2010like diuretics per 10\u2009000 persons. Using segmented linear regression, we quantified the pre\u2010DHPC trend, the immediate change and the post\u2010DHPC change in trend for total claims and DDD for the four drug classes weighted for the demographic distribution of the Swiss population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ACE inhibitors and ARB were the most frequently claimed antihypertensive drugs with 300\u2013400 claims per 10\u2009000 persons, which increased by 5.4% during the study period. The average number of hydrochlorothiazide claims (157\/10\u2009000 persons in 2015) declined by 35% between 2015 and 2021. The decrease started prior to the DHPC, but the DHPC was associated with an immediate 6.1% decline and an accelerated decline in claims over time after the DHPC (similar results for DDD). This coincided with a 23% increase in claims of CCB (dihydropyridine type) over 7\u2009years, whereas use of other antihypertensives increased less.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results suggest that the DHPC by Swissmedic in 2018 accelerated a pre\u2010existing decline in the use of hydrochlorothiazide in Switzerland.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.70005","type":"journal-article","created":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T07:05:47Z","timestamp":1725347147000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Changes in the Use of Hydrochlorothiazide and Other Antihypertensive Drugs in Switzerland in Association With the Swissmedic Safety Alert Regarding Non\u2010melanoma Skin Cancer: An Interrupted Time\u2010Series Analysis Using Swiss Claims Data"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6382-9645","authenticated-orcid":false,"given":"Tamino","family":"Zappal\u00e0","sequence":"first","affiliation":[{"name":"Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9314-5679","authenticated-orcid":false,"given":"Anton","family":"Potteg\u00e5rd","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2469-0435","authenticated-orcid":false,"given":"Carola\u00a0A.","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Helsana Group  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9123-6590","authenticated-orcid":false,"given":"Daphne","family":"Reinau","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy University Hospital Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7120-6378","authenticated-orcid":false,"given":"Christoph\u00a0R.","family":"Meier","sequence":"additional","affiliation":[{"name":"Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences University of Basel  Basel Switzerland"},{"name":"Hospital Pharmacy University Hospital Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1632-1928","authenticated-orcid":false,"given":"Julia","family":"Spoendlin","sequence":"additional","affiliation":[{"name":"Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences University of Basel  Basel Switzerland"},{"name":"Hospital Pharmacy University Hospital Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy339"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12629"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.11.042"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.1652"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14245"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.13463"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02560220"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5295"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.08.025"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264\u2010020\u201001015\u20101"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkab009"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19880"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12921"},{"key":"e_1_2_10_15_1","first-page":"1","article-title":"DHPC\u2014Pr\u00e4parate mit Wirkstoff Hydrochlorothiazid (HCTZ oder auch HCT genannt)","author":"Swissmedic","year":"2018","journal-title":"Direct Helthcare Professional Communications"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5350"},{"key":"e_1_2_10_17_1","unstructured":"A. G.Helsana Versicherungen \u201cHelsana\u2014Facts & Figures. Gesch\u00e4ftsbericht 2021 \u201d2021 https:\/\/annualreport.helsana.ch\/21\/de\/finanzen\/facts\u2010figures.html."},{"key":"e_1_2_10_18_1","unstructured":"Norwegian Institute of Public Health \u201cWHO Collaborating Centre for Drug Statistics Methodology \u201dATC\/DDD Index accessed August 19 2022 https:\/\/www.whocc.no\/atc_ddd_index\/."},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht151"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2020.0687"},{"key":"e_1_2_10_21_1","unstructured":"Swiss Society of Hypertension (SSH) \u201cHydrochlorothiazid Und Hautkrebs: Mahnung Zur Vorsicht. Stellungnahme Der Schweizerischen Gesellschaft F\u00fcr Hypertonie Und Der Schweizerischen Gesellschaft F\u00fcr Dermatologie Und Venerologie \u201d2019 https:\/\/swisshypertension.ch\/DOCS_PUBLIC\/StatementHCTZSkinCancer_E_Z.pdf."},{"key":"e_1_2_10_22_1","unstructured":"Swiss Society of Hypertension (SSH) \u201cArterielle Hypertonie\u2014Empfehlungen f\u00fcr \u00c4rzte \u201d2019 https:\/\/www.swisshypertension.ch\/public\/guidelines\/guidelines_english.html."}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T06:59:57Z","timestamp":1733295597000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.70005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1002\/pds.70005"],"URL":"https:\/\/doi.org\/10.1002\/pds.70005","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]},"assertion":[{"value":"2023-12-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70005"}}