{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T20:54:39Z","timestamp":1771966479118,"version":"3.50.1"},"reference-count":75,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Medication use assessment has a critical role in promoting the effective and rational use of pharmaceutical medications. There are no studies that have explored the utilization of all medications in England and Wales in the past 15\u00a0years without restrictions in the age group being studied or class of medications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aim<\/jats:title>\n                <jats:p>To explore the medication utilization pattern of dispensed medications in England and Wales in the past 15\u00a0years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>A secular trend analysis study using publically available dispensing data on the population level in England and Wales for the duration between 2004 and 2019. Medication dispensing data was extracted from the Prescription Cost Analysis database.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Medication prescriptions rate increased by 42.6% [from 1,345,095.75 (95% CI 1,345,004.25 \u2013 1,345,187.26) in 2004 to 1,918,138.48 (95% CI 1,918,038.38 \u2013 1,918,238.57) in 2019 per 100,000 persons, trend test, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001]. During the study period, the most common medication prescriptions were for the cardiovascular system, central nervous system, and endocrine system, which accounted for 30.2%, 18.8%, and 9.4%, respectively. The rate of medication prescriptions for skin, immunological products and vaccines, infections, and musculoskeletal and joint diseases decreased by 18.4%, 15.8%, 9.8%, and 5.7%, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The last two decades have witnessed a remarkable rise in the quantity of medications dispensed in community settings. Utilization of chronic disease medications has increased in the past 15\u00a0years, specifically, dispensed medications for the cardiovascular system, central nervous system, and endocrine system. It is necessary to conduct additional cohort studies to investigate the clinical outcomes\u00a0and prescribing safety of these medications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12875-022-01853-1","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T16:03:10Z","timestamp":1663344190000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Drugs utilization profile in England and Wales in the past 15\u00a0years: a secular trend analysis"],"prefix":"10.1186","volume":"23","author":[{"given":"Abdallah Y.","family":"Naser","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Alwafi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara","family":"Al-Daghastani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara Ibrahim","family":"Hemmo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamzeh Mohammad","family":"Alrawashdeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahraa","family":"Jalal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vibhu","family":"Paudyal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nawras","family":"Alyamani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murouj","family":"Almaghrabi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Shamieh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,16]]},"reference":[{"key":"1853_CR1","volume-title":"The global use of medicine in 2019 and outlook to 2023","author":"IQVIA","year":"2019","unstructured":"IQVIA. The global use of medicine in 2019 and outlook to 2023. 2019. Available from: https:\/\/www.iqvia.com\/insights\/the-iqvia-institute\/reports\/the-global-use-of-medicine-in-2019-and-outlook-to-2023. Aug 16, 2022."},{"issue":"6","key":"1853_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41408-020-0338-x","volume":"10","author":"S Vincent Rajkumar","year":"2020","unstructured":"Vincent Rajkumar S. The high cost of prescription drugs: causes and solutions. Blood Cancer J. 2020;10(6):1\u20135.","journal-title":"Blood Cancer J"},{"key":"1853_CR3","doi-asserted-by":"publisher","first-page":"S6","DOI":"10.3122\/jabfm.2012.02.110200","volume":"25","author":"M Roland","year":"2012","unstructured":"Roland M, Guthrie B, Thom\u00e9 D. Primary medical care in the United Kingdom. J Am Board Fam Med. 2012;25:S6-11.","journal-title":"J Am Board Fam Med"},{"key":"1853_CR4","unstructured":"The Health and Social Care Information Centre, Prescriptions Dispensed in the Community: England, Statistics for 2001 to 2011. 2011. p. 1-33."},{"issue":"2","key":"1853_CR5","doi-asserted-by":"publisher","first-page":"86","DOI":"10.4103\/2229-3485.154005","volume":"6","author":"S Jain","year":"2015","unstructured":"Jain S, et al. A systematic review of prescription pattern monitoring studies and their effectiveness in promoting rational use of medicines. Perspect Clin Res. 2015;6(2):86\u201390.","journal-title":"Perspect Clin Res"},{"issue":"1","key":"1853_CR6","doi-asserted-by":"publisher","first-page":"10","DOI":"10.4103\/0970-0218.62546","volume":"35","author":"S Kar","year":"2010","unstructured":"Kar S, Pradhan H, Mohanta G. Concept of essential medicines and rational use in public health. Indian J Community Med. 2010;35(1):10\u20133.","journal-title":"Indian J Community Med"},{"key":"1853_CR7","unstructured":"World Health Organization, The Pursuit of Responsible Use of Medicines: Sharing and Learning from Country Experiences. World Health Organization; 2012. p. 1\u201378. Available at: https:\/\/apps.who.int\/iris\/handle\/10665\/75828?locale-attribute=en&."},{"issue":"4","key":"1853_CR8","first-page":"519","volume":"35","author":"TT de Souza","year":"2014","unstructured":"de Souza TT, et al. Morbidade e mortalidade relacionadas a medicamentos no Brasil: revis\u00e3o sistem\u00e1tica de estudos observacionais. Rev Ci\u00eanc Farm B\u00e1sica Apl. 2014;35(4):519\u201332.","journal-title":"Rev Ci\u00eanc Farm B\u00e1sica Apl"},{"key":"1853_CR9","first-page":"1","volume":"2020","author":"Z Yilma","year":"2020","unstructured":"Yilma Z, Liben M. Assessment of Drug Prescription Pattern in Mekelle General Hospital, Mekelle, Ethiopia, Using World Health Organization Prescribing Indicators. Biomed Res Int. 2020;2020:1\u20136.","journal-title":"Biomed Res Int"},{"issue":"3","key":"1853_CR10","doi-asserted-by":"publisher","first-page":"163","DOI":"10.6061\/clinics\/2014(03)03","volume":"69","author":"FR Varallo","year":"2014","unstructured":"Varallo FR, Capucho HC, Silva Planeta CD, CarvalhoMastroianni PD. Possible adverse drug events leading to hospital admission in a Brazilian teaching hospital. Clinics (Sao Paulo, Brazil). 2014;69(3):163\u20137.","journal-title":"Clinics (Sao Paulo, Brazil)"},{"issue":"3","key":"1853_CR11","first-page":"P170","volume":"4","author":"RR Kondra","year":"2013","unstructured":"Kondra RR, Ghongane BB. Drug utilization research: Need of the hour. Int J Pharm Bio Sci. 2013;4(3):P170\u20138.","journal-title":"Int J Pharm Bio Sci"},{"key":"1853_CR12","unstructured":"Office for National Statistics. United Kingdom Health Statistics, 2000. 2001 December 28, 2021]; Available from: https:\/\/webarchive.nationalarchives.gov.uk\/ukgwa\/20160114055231\/http:\/\/www.ons.gov.uk\/ons\/rel\/ukhs\/united-kingdom-health-statistics\/2000\/index.html."},{"key":"1853_CR13","unstructured":"Office for National Statistics. United Kingdom Health Statistics , 2009. 2009 December 28, 2021]; Available from: https:\/\/webarchive.nationalarchives.gov.uk\/ukgwa\/20160114055222\/http:\/\/www.ons.gov.uk\/ons\/rel\/ukhs\/united-kingdom-health-statistics\/2009\/index.html."},{"issue":"144","key":"1853_CR14","first-page":"1","volume":"16","author":"A Bilal","year":"2016","unstructured":"Bilal A, Osman E, Mulugeta A. Assessment of medicines use pattern using World Health Organization\u2019s Prescribing, Patient Care and Health facility indicators in selected health facilities in eastern Ethiopia. BMC Health Serv Res. 2016;16(144):1\u20138.","journal-title":"BMC Health Serv Res"},{"key":"1853_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/4173586","volume":"2020","author":"K Mishore","year":"2020","unstructured":"Mishore K, et al. Evaluation of Drug Use Pattern in Emergency Department of Dilchora Referral Hospital, Dire Dawa. Ethiopia Emerg Med Int. 2020;2020:1\u20136.","journal-title":"Ethiopia. Emerg Med Int"},{"key":"1853_CR16","first-page":"77","volume":"4","author":"V Pavani","year":"2011","unstructured":"Pavani V, et al. Study of Prescribing Pattern for Evaluation of Rational Drug Therapy in Warangal. Andhra Pradesh-506001 India Study of Prescribing Pattern for Evaluation of Rational Drug Therapy in Warangal. Andhra Pradesh-506001 India. J Pharm Pract. 2011;4:77\u20139.","journal-title":"J Pharm Pract"},{"issue":"16","key":"1853_CR17","first-page":"1","volume":"10","author":"B Hovstadius","year":"2010","unstructured":"Hovstadius B, et al. Increasing polypharmacy - an individual-based study of the Swedish population 2005\u20132008. BMC Clin Pharmacol. 2010;10(16):1\u20138.","journal-title":"BMC Clin Pharmacol"},{"issue":"12","key":"1853_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjopen-2020-041529","volume":"10","author":"D Abrahami","year":"2020","unstructured":"Abrahami D, McDonald EG, Schnitzer M, Azoulay L. Trends in acid suppressant drug prescriptions in primary care in the UK: a population-based cross-sectional study. BMJ Open. 2020;10(12):1\u20137.","journal-title":"BMJ Open"},{"issue":"13","key":"1853_CR19","doi-asserted-by":"publisher","first-page":"7041","DOI":"10.3390\/ijerph18137041","volume":"18","author":"SI Hemmo","year":"2021","unstructured":"Hemmo SI, et al. Hospital Admissions Due to Ischemic Heart Diseases and Prescriptions of Cardiovascular Diseases Medications in England and Wales in the Past Two Decades. Int J Environ Res Public Health. 2021;18(13):7041.","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"1853_CR20","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1007\/s13300-017-0349-1","volume":"9","author":"AY Naser","year":"2018","unstructured":"Naser AY, et al. Hospital Admissions due to Dysglycaemia and Prescriptions of Antidiabetic Medications in England and Wales: An Ecological Study. Diabetes Ther. 2018;9(1):153\u201363.","journal-title":"Diabetes Ther"},{"key":"1853_CR21","doi-asserted-by":"publisher","first-page":"S37","DOI":"10.1192\/bjp.195.52.s37","volume":"52","author":"TR Barnes","year":"2009","unstructured":"Barnes TR, Shingleton-Smith A, Paton C. Antipsychotic long-acting injections: prescribing practice in the UK. Br J Psychiatry. 2009;52:S37\u201342.","journal-title":"Br J Psychiatry"},{"key":"1853_CR22","doi-asserted-by":"crossref","unstructured":"Al-Daghastani T, Naser AY. Hospital admission profile related to poisoning by, adverse effect of and underdosing of psychotropic drugs in England and Wales: An ecological study. Saudi Pharmaceutical Journal. 2022. In press, Available at: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S1319016422001827.","DOI":"10.1016\/j.jsps.2022.06.025"},{"key":"1853_CR23","volume-title":"Prescription Cost Analysis","author":"National Health Service","year":"2021","unstructured":"National Health Service. Prescription Cost Analysis. 2021. Available from: https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/prescription-cost-analysis. March 01, 2021."},{"key":"1853_CR24","unstructured":"Welsh Government, Prescribing statistics quality report. 2012. p. 1\u20139. Available at: https:\/\/llyw.cymru\/sites\/default\/files\/statistics-and-research\/2018-11\/adroddiad-ansawdd-ystadegau-presgripsiynau.pdf."},{"key":"1853_CR25","unstructured":"OpenPrescribing. All BNF sections. 2021 ; Available from: https:\/\/openprescribing.net\/bnf\/.\u00a0 01 March\u00a0 \u00a02021"},{"key":"1853_CR26","volume-title":"BNF Publications: Our organisation and history","author":"Joint Formulary Committee","year":"2021","unstructured":"Joint Formulary Committee. BNF Publications: Our organisation and history. 2021. Available from: https:\/\/www.bnf.org\/about\/. July 23, 2022."},{"key":"1853_CR27","unstructured":"National Health Services, BNF Classification and Pseudo Classification Used by the NHS Prescription Services. 2017. p. 1\u201312. Available at: https:\/\/www.nhsbsa.nhs.uk\/nhs-prescription-services."},{"key":"1853_CR28","volume-title":"Medicines information","author":"National Health Services","year":"2020","unstructured":"National Health Services. Medicines information. 2020. Available from: https:\/\/www.nhs.uk\/conditions\/medicines-information\/. July 25, 2022."},{"issue":"11","key":"1853_CR29","doi-asserted-by":"publisher","first-page":"e29","DOI":"10.2105\/AJPH.2015.302843","volume":"105","author":"S Martins","year":"2015","unstructured":"Martins S, et al. Worldwide Prevalence and Trends in Unintentional Drug Overdose: A Systematic Review of the Literature. Am J Public Health. 2015;105(11):e29-49.","journal-title":"Am J Public Health"},{"key":"1853_CR30","unstructured":"Statista. Global spending on medicines in 2010, 2020, and a forecast for 2025. 2021 April, 2021 Novemeber, 13, 2021]; Available from: https:\/\/www.statista.com\/statistics\/280572\/medicine-spending-worldwide\/."},{"issue":"1","key":"1853_CR31","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1111\/acps.13116","volume":"141","author":"R Wesselhoeft","year":"2020","unstructured":"Wesselhoeft R, et al. Trends in antidepressant use among children and adolescents: a Scandinavian drug utilization study. Acta Psychiatr Scand. 2020;141(1):34\u201342.","journal-title":"Acta Psychiatr Scand"},{"issue":"2","key":"1853_CR32","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1002\/phar.2217","volume":"39","author":"K Kristensen","year":"2019","unstructured":"Kristensen K, et al. Nonaspirin Nonsteroidal Antiinflammatory Drug Use in the Nordic Countries from a Cardiovascular Risk Perspective, 2000\u20132016: A Drug Utilization Study. Pharmacotherapy. 2019;39(2):150\u201360.","journal-title":"Pharmacotherapy"},{"issue":"3","key":"1853_CR33","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1515\/sjpain-2018-0342","volume":"19","author":"L Jarlbaek","year":"2019","unstructured":"Jarlbaek L. Opioid prescribing habits differ between Denmark, Sweden and Norway - and they change over time. Scand J Pain. 2019;19(3):491\u20139.","journal-title":"Scand J Pain"},{"issue":"4","key":"1853_CR34","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1007\/s40801-019-00163-w","volume":"6","author":"SK Nissen","year":"2019","unstructured":"Nissen SK, Potteg\u00e5rd A, Ryg J. Trends of Opioid Utilisation in Denmark: A Nationwide Study. Drugs - real world outcomes. 2019;6(4):155\u201364.","journal-title":"Drugs - real world outcomes"},{"issue":"4","key":"1853_CR35","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1016\/j.amjcard.2019.11.009","volume":"125","author":"CB Poulsen","year":"2020","unstructured":"Poulsen CB, Damkj\u00e6r M, L\u00f8fgren B, Schmidt M. Trends in Antiarrhythmic Drug Use in Denmark Over 19 Years. Am J Cardiol. 2020;125(4):562\u20139.","journal-title":"Am J Cardiol"},{"issue":"1","key":"1853_CR36","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1186\/s12890-021-01736-8","volume":"21","author":"AY Naser","year":"2021","unstructured":"Naser AY, et al. Hospital admission trends due to respiratory diseases in England and Wales between 1999 and 2019: an ecologic study. BMC Pulm Med. 2021;21(1):356.","journal-title":"BMC Pulm Med"},{"issue":"21","key":"1853_CR37","doi-asserted-by":"publisher","first-page":"11649","DOI":"10.3390\/ijerph182111649","volume":"18","author":"AY Naser","year":"2021","unstructured":"Naser AY, et al. Hospital Admission Trends Due to Viral Infections Characterised by Skin and Mucous Membrane Lesions in the Past Two Decades in England and Wales: An Ecological Study. Int J Environ Res Public Health. 2021;18(21):11649.","journal-title":"Int J Environ Res Public Health"},{"issue":"25","key":"1853_CR38","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","volume":"76","author":"GA Roth","year":"2020","unstructured":"Roth GA, Mensah G, Johnson CO, Addolorato G, Ammirati E, Baddour LM, Barengo NC, Beaton AZ, Benjamin EJ, Benziger CP, Bonny A, Brauer M, Brodmann M, Cahill TJ, Carapetis J, Catapano AL, Chugh SS, Cooper LT, Coresh J, Criqui M, DeCleene N, Eagle KA, Emmons-Bell S, Feigin VL, Fern\u00e1ndez-Sol\u00e0 J, Fowkes G, Gakidou E, Grundy SM, He FJ, Howard G, Hu F, Inker L, Karthikeyan G, Kassebaum N, Koroshetz W, Lavie C, Lloyd-Jones D, Lu HS, Mirijello A, Temesgen AM, Mokdad A, Moran AE, Muntner P, Narula J, Neal B, Ntsekhe M. GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group., Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020;76(25):2982\u20133021.","journal-title":"J Am Coll Cardiol"},{"issue":"15","key":"1853_CR39","first-page":"1","volume":"5","author":"G Lippi","year":"2020","unstructured":"Lippi G, Sanchis-Gomar F. Global epidemiology and future trends of heart failure. AME Med J. 2020;5(15):1\u20136.","journal-title":"AME Med J"},{"key":"1853_CR40","unstructured":"Public Health England, Hypertension prevalence estimates in England, 2017 Estimated from the Health Survey for England. 2020. p. 1\u201312. Available at: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/873605\/Summary_of_hypertension_prevalence_estimates_in_England__1_.pdf."},{"key":"1853_CR41","unstructured":"National Health Service. Health Survey for England 2015. 2016 14 December 2016 Novemeber, 13, 2021]; Available from: https:\/\/www.gov.uk\/government\/statistics\/health-survey-for-england-health-survey-for-england-2015."},{"issue":"12","key":"1853_CR42","first-page":"2177","volume":"146","author":"K Quinn","year":"1992","unstructured":"Quinn K, Baker M, Evans B. A population-wide profile of prescription drug use in Saskatchewan, 1989. CMAJ. 1992;146(12):2177\u201386.","journal-title":"CMAJ"},{"issue":"38","key":"1853_CR43","first-page":"1","volume":"17","author":"A Thompson","year":"2016","unstructured":"Thompson A, et al. The influence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study. BMC Fam Pract. 2016;17(38):1\u20137.","journal-title":"BMC Fam Pract"},{"issue":"11","key":"1853_CR44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ijerph17113926","volume":"17","author":"V Orlando","year":"2020","unstructured":"Orlando V, et al. Gender Differences in Medication Use: A Drug Utilization Study Based on Real World Data. Int J Environ Res Public Health. 2020;17(11):1\u201310.","journal-title":"Int J Environ Res Public Health"},{"issue":"11","key":"1853_CR45","doi-asserted-by":"publisher","first-page":"e014742","DOI":"10.1161\/JAHA.119.014742","volume":"9","author":"M Zhao","year":"2020","unstructured":"Zhao M, Woodward M, Vaartjes I, Millett E, Klipstein-Grobusch K, Hyun K, Carcel C, Peters S. Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2020;9(11):e014742.","journal-title":"J Am Heart Assoc"},{"key":"1853_CR46","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1016\/S0002-9149(98)00507-4","volume":"82","author":"R Weiss","year":"1998","unstructured":"Weiss R, Ferry D, Pickering E, Smith L, Dennish G, Krug-Gourley S, Lukas M. Effectiveness of three different doses of carvedilol for exertional angina Carvedilol-Angina Study Group. Am J Cardiol. 1998;82:927\u201331.","journal-title":"Am J. Cardiol"},{"key":"1853_CR47","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1016\/0002-9149(76)90293-9","volume":"37","author":"S Warren","year":"1976","unstructured":"Warren S, Brewer D, Orgain E. Long-term propranolol therapy for angina pectoris. Am J Cardiol. 1976;37:420\u20136.","journal-title":"Am J Cardiol"},{"key":"1853_CR48","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1001\/jama.1993.03510130095038","volume":"270","author":"K Teo","year":"1993","unstructured":"Teo K, Yusuf S, Furberg C. Effects of prophylactic antiarrhythmic drug therapy in acute myocardial infarction. An overview of results from randomized controlled trials. JAMA. 1993;270:1589\u201395.","journal-title":"JAMA"},{"key":"1853_CR49","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1056\/NEJM199802193380807","volume":"338","author":"J Parker","year":"1998","unstructured":"Parker J, Parker JO. Nitrate therapy for stable angina pectoris. N Engl J Med. 1998;338:520\u201331.","journal-title":"N Engl J Med"},{"key":"1853_CR50","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1093\/eurheartj\/ehr035","volume":"32","author":"E Mills","year":"2011","unstructured":"Mills E, O\u2019Rrgan C, Eyawo O, Wu P, Mills F, Berwanger O, Briel M. Intensive statin therapy compared with moderate dosing for prevention of cardiovascular events: A meta-analysis of >40,000 patients. Eur Heart J. 2011;32:1409\u201315.","journal-title":"Eur Heart J"},{"issue":"10120","key":"1853_CR51","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/S0140-6736(17)32520-5","volume":"291","author":"N Conrad","year":"2018","unstructured":"Conrad N, Judge A, Tran J, Mohseni H, Hedgecott D, Crespillo AP, Allison M, Hemingway H, Cleland JG, McMurray J, Rahimi K. Temporal trends and patterns in heart failure incidence: A population-based study of 4 million individuals. Lancet. 2018;291(10120):572\u201380.","journal-title":"Lancet"},{"key":"1853_CR52","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1016\/0735-1097(90)90282-T","volume":"15","author":"AS Agatston","year":"1990","unstructured":"Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR Jr, Viamonte M, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15:827\u201332.","journal-title":"J Am Coll Cardiol"},{"key":"1853_CR53","first-page":"1","volume":"377","author":"D Brody","year":"2020","unstructured":"Brody D, Gu Q. Antidepressant Use Among Adults: United States, 2015\u20132018. NCHS Data Brief. 2020;377:1\u20138.","journal-title":"NCHS Data Brief"},{"issue":"9","key":"1853_CR54","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjopen-2019-034346","volume":"10","author":"N Slater","year":"2020","unstructured":"Slater N, White S, Frisher M. Central nervous system (CNS) medications and polypharmacy in later life: cross-sectional analysis of the English Longitudinal Study of Ageing (ELSA). BMJ Open. 2020;10(9):1\u20138.","journal-title":"BMJ Open"},{"key":"1853_CR55","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1159\/000495813","volume":"52","author":"Y B\u00e9jot","year":"2019","unstructured":"B\u00e9jot Y, Yaffe K. Ageing Population: A Neurological Challenge. Neuroepidemiology. 2019;52:76\u20137.","journal-title":"Neuroepidemiology"},{"key":"1853_CR56","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1038\/s41582-019-0244-7","volume":"15","author":"Y Hou","year":"2019","unstructured":"Hou Y, Dan X, Babbar M, Wei Y, Hasselbalch SG, Croteau DL, Bohr VA. Ageing as a risk factor for neurodegenerative disease. Nat Rev Neurol. 2019;15:565\u201381.","journal-title":"Nat Rev Neurol"},{"key":"1853_CR57","unstructured":"Office for National Statistics. Population estimates. 2022 July 23, 2022]; Available from: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/populationandmigration\/populationestimates\/datasets\/populationestimatesforukenglandandwalesscotlandandnorthernireland. 2022 July 23"},{"key":"1853_CR58","unstructured":"Agronin ME, Maletta GJ. Principles and Practice of Geriatric Psychiatry. 2005. p. 721\u201334. Available from: https:\/\/www.abebooks.com\/9781605476001\/Principles-Practice-Geriatric-Psychiatry-Agronin-1605476005\/plp."},{"issue":"5","key":"1853_CR59","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1177\/106002809202600514","volume":"26","author":"J Hanlon","year":"1992","unstructured":"Hanlon J, et al. Drug-use patterns among black and nonblack community-dwelling elderly. Ann Pharmacother. 1992;26(5):679\u201385.","journal-title":"Ann Pharmacother"},{"issue":"2","key":"1853_CR60","doi-asserted-by":"publisher","first-page":"169","DOI":"10.7326\/0003-4819-107-2-169","volume":"107","author":"E Larson","year":"1987","unstructured":"Larson E, et al. Adverse drug reactions associated with global cognitive impairment in elderly persons. Ann Intern Med. 1987;107(2):169\u201373.","journal-title":"Ann Intern Med"},{"key":"1853_CR61","unstructured":"Janeway C, et al. Immunobiology: The Immune System in Health and Disease. 5th edition ed. In: Janeway C, editor. Churchill Livingstone; 2001. Available from: http:\/\/link.archive.org\/portal\/Immunobiology--the-immune-system-in-health-and\/JzN_Pxx46BE\/."},{"key":"1853_CR62","unstructured":"World Health Organization. Diabetes. 2021 10 November 2021 Novemeber 13, 2021]; Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diabetes."},{"key":"1853_CR63","unstructured":"Diabetes.co.uk. Diabetes Prevalence. 2019 15th January 2019 Novemeber 13, 2021]; Available from: https:\/\/www.diabetes.co.uk\/diabetes-prevalence.html."},{"key":"1853_CR64","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.diabres.2019.107843","volume":"157","author":"P Saeedi","year":"2019","unstructured":"Saeedi P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2019;157:1\u201310.","journal-title":"Diabetes Res Clin Pract"},{"issue":"1","key":"1853_CR65","doi-asserted-by":"publisher","first-page":"1","DOI":"10.47275\/2692-0964-104","volume":"1","author":"HM Alrawashdeh","year":"2020","unstructured":"Alrawashdeh HM. An Overview of Diabetic Retinopathy. Obesity and Diabetes Research. 2020;1(1):1\u20133.","journal-title":"Obesity and Diabetes Research"},{"key":"1853_CR66","doi-asserted-by":"crossref","unstructured":"Schulze M, et al. Food based dietary patterns and chronic disease prevention. BMJ. 2018;361(k2396):1-6. Available from: https:\/\/www.bmj.com\/content\/361\/bmj.k2396.long.","DOI":"10.1136\/bmj.k2396"},{"issue":"6","key":"1853_CR67","first-page":"537","volume":"161","author":"P Adami","year":"2010","unstructured":"Adami P, et al. The role of physical activity in the prevention and treatment of chronic diseases. Clin Ter. 2010;161(6):537\u201341.","journal-title":"Clin Ter"},{"issue":"4","key":"1853_CR68","first-page":"223","volume":"29","author":"J Harrison","year":"1998","unstructured":"Harrison J, Svec T. The beginning of the end of the antibiotic era? Part II. Proposed solutions to antibiotic abuse. Quintessence Int. 1998;29(4):223\u20139.","journal-title":"Quintessence Int"},{"key":"1853_CR69","unstructured":"World Health Organization. Antimicrobial resistance. 2020 13 October 2020 Novemeber 13, 2021]; Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/antimicrobial-resistance."},{"issue":"2","key":"1853_CR70","first-page":"169","volume":"20","author":"AR Alnemri","year":"2016","unstructured":"Alnemri AR, et al. Misuse of antibiotic: A systemic review of Saudi published studies. Curr Pediatr Res. 2016;20(2):169\u201373.","journal-title":"Curr Pediatr Res"},{"key":"1853_CR71","first-page":"81","volume":"5","author":"A Amin","year":"2009","unstructured":"Amin A, et al. Prevalence of antibiotic resistance among clinical isolates of Kleibsiella pneumoniae isolated from a Tertiary Care Hospital in Pakistan. Malaysian J Microbiol. 2009;5:81\u20136.","journal-title":"Malaysian J Microbiol"},{"key":"1853_CR72","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1007\/s13213-014-0911-2","volume":"64","author":"M Piotrowska","year":"2014","unstructured":"Piotrowska M, Popowska M. The prevalence of antibiotic resistance genes among Aeromonas species in aquatic environments. Ann Microbiol. 2014;64:921\u201334.","journal-title":"Ann Microbiol"},{"key":"1853_CR73","volume-title":"Scottish Reduction in Antimicrobial Prescribing (ScRAP)","author":"HAI Education for Infection and Prevenetion Control","year":"2022","unstructured":"HAI Education for Infection and Prevenetion Control. Scottish Reduction in Antimicrobial Prescribing (ScRAP). 2022. Available from: https:\/\/learn.nes.nhs.scot\/7570\/infection-prevention-and-control-ipc-zone\/sipcep-intermediate-layer\/antibiotic-management\/scottish-reduction-in-antimicrobial-prescribing-scrap. July 25, 2022."},{"key":"1853_CR74","volume-title":"Respiartory Infections","author":"National Institute for Health and Care Excellence","year":"2013","unstructured":"National Institute for Health and Care Excellence. Respiartory Infections. 2013. Available from: https:\/\/www.nice.org.uk\/sharedlearning\/reducing-antibiotic-prescribing-by-15-using-nice-respiratory-tract-illness-prescribing-guidelines. July 25, 2022"},{"key":"1853_CR75","unstructured":"Public Health England. News story. 2018; Available from: https:\/\/www.gov.uk\/government\/news\/financial-incentives-effective-at-reducing-antibiotic-prescribing. July 25, 2022."}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-022-01853-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-022-01853-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-022-01853-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T18:07:03Z","timestamp":1663351623000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcfampract.biomedcentral.com\/articles\/10.1186\/s12875-022-01853-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,16]]},"references-count":75,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1853"],"URL":"https:\/\/doi.org\/10.1186\/s12875-022-01853-1","relation":{},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,16]]},"assertion":[{"value":"1 February 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"239"}}