Anton Pottegård

Anton Pottegård
University of Southern Denmark | SDU · Clinical Pharmacology and Pharmacy, Department of Public Health

Pharmacist, PhD

About

424
Publications
65,251
Reads
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6,589
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Introduction
Analyzing data on use patterns and effects / side effects of medicines to support the most rational use of drugs. Professor of pharmacoepidemiology and clinical pharmacy at the University of Southern Denmark. Also Head of Research at Hospital Pharmacy Funen at the Odense University Hospital, where we primarily do clinical research centered around deprescribing. If you wish to get hold of me, you can do so at 0045 28913340 or apottegaard@health.sdu.dk
Additional affiliations
January 2012 - present
Position
  • Pharmacoepidemiological Aspects of Vitamin K Antagonist Treatment
October 2011 - December 2011
Position
  • ADHD in Denmark (Drug utilization study)
Education
September 2009 - August 2011
September 2006 - June 2009

Publications

Publications (424)
Article
Knowledge of patterns of treatment discontinuation in ADHD drug treatment is of importance, both for clinical practice and the study of long-term treatment outcomes. The purpose of this study was to describe early discontinuation of ADHD drug treatment.Using the Danish National Prescription Registry, all first-time users of the ADHD drugs methylphe...
Article
Background Detailed data on real-life utilization of vitamin K-antagonists (VKA) and new oral anticoagulants (NOAC) in atrial fibrillation is sparse.Objectives To describe dynamics of VKA and NOAC use, i.e. 1) how patients moved in and out of, as well as between, use of VKA and NOAC, 2) how patients adhered to treatment; and 3) which type of prescr...
Article
The use of methylphenidate to treat attention-deficit/hyperactivity disorder has risen dramatically in Western countries, and it is increasingly used by adults, including women of childbearing age. Very little is known about potential hazards of in utero exposure to methylphenidate. We conducted this study to estimate the risk of major congenital m...
Article
Aim: Studies of the carcinogenic potential of benzodiazepines and related drugs (BZRD) have been equivocal. A recent study reported a 35% excess cancer risk among users of hypnotics, including benzodiazepines. Method: Using Danish nationwide registers, we conducted a matched case-control study of the association between BZRD and cancer risk. Dur...
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The purpose of the study was to characterize the utilization of medication against attention deficit hyperactivity disorder (ADHD) in Denmark between 1995 and 2011 from a national perspective, by using population-based prescription data. National data on drug use in Denmark between 1 January 1995 and 30 September 2011 were extracted from the Regist...
Article
The main tool in drug safety monitoring, spontaneous reporting of adverse effects, is unlikely to detect delayed adverse drug effects including cancer. Hypothesis-free screening studies based on administrative data could improve ongoing drug safety monitoring. Using Danish health registries, we conducted a series of case-control studies by identify...
Article
Background Repeated oral corticosteroid use indicates uncontrolled disease among asthma patients and referral for asthma specialist assessment is recommended. We aimed to describe trends and predictors associated with specialist contacts among young adults with asthma and repeated oral corticosteroid use. Methods Individuals aged 18–45 years with...
Article
Background: Symptoms and treatment of benign prostatic hyperplasia (BPH) or erectile dysfunction (ED) may lead to prostate cancer workup, and patterns of prescriptions before diagnosis may affect findings of pharmacoepidemiological studies. Usage of BPH and ED drugs after diagnosis may be related to prostate cancer treatment. We investigated diffe...
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The second‐generation antipsychotic quetiapine is commonly used off‐label for its anxiolytic and hypnotic properties. However, quetiapine is associated with problematic side‐effects. We used Danish Medicinal Product Statistics and a 20% random sample of the Danish population’s prescription fills (2001‐2020) to describe the utilization of quetiapine...
Article
In this review paper, I outline the principles of the cohort as a sampling frame and provide a basic introduction to the cohort study design and the case–control study design, two of the most important designs in the pharmacoepidemiologist's toolbox. Further, I discuss when to prefer one design over the other. The paper is intended as a primer for...
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Objectives To assess the risk of acute and post-acute adverse events after SARS-CoV-2 infection in children and adolescents in Denmark and to evaluate the real world effectiveness of the BNT162b2 mRNA vaccine (Pfizer-BioNTech) among adolescents. Design Cohort study. Setting Nationwide Danish healthcare registers. Participants All Danish people y...
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Purpose: To develop the Nordic Multimorbidity Index (NMI), a multimorbidity measure specifically suited to the Nordic health and administrative registry data based on current diagnosis, treatment, and coding practices. Methods: The NMI was developed to predict 5-year mortality in a population-based cohort of randomly sampled Danish residents age...
Preprint
Aims The Danish authorities implemented a differential rollout of the COVID-19 vaccines where individuals at high risk of COVID-19 were prioritized. We describe the temporal uptake of COVID-19 vaccines and changing characteristics of vaccine recipients in Denmark. Methods Using the Danish national health care registries, we identified all Danish r...
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Background and objectives: Aclidinium bromide was approved in the European Union for the treatment of chronic obstructive pulmonary disease (COPD) in adult patients in 2012 and in a fixed-dose combination with formoterol in 2014. We characterised new users of aclidinium, aclidinium/formoterol and other COPD medications and evaluated off-label pres...
Article
Aims: There is currently no consensus on whether atrial fibrillation (AF) patients at low risk for stroke (one non-sex-related CHA2DS2-VASc point) should be treated with an oral anticoagulant. Methods and results: We conducted a multi-country cohort study in Sweden, Denmark, Norway, and Scotland. In total, 59 076 patients diagnosed with AF at lo...
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PurposeTo investigate differences in prescription rates of commonly used drugs among prostate cancer patients and cancer-free comparisons and between patients diagnosed with localized and non-localized disease.Methods We conducted a register-based study including all men aged 50–85 years diagnosed with prostate cancer in Denmark from 1998 to 2015 a...
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Background Older migrants with cognitive impairment exposed to polypharmacy constitute a vulnerable group of patients. To our knowledge, evidence on medication safety among this patient group with multiple risk factors is lacking. Objectives To explore the perspectives of health care professionals on medication safety among older migrants with cog...
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Objectives To evaluate safety and effectiveness of prophylactic anticoagulation with low molecular weight heparin (LMWH) in individuals hospitalised for COVID-19. Methods Using healthcare records from the capital region of Denmark (March 2020-February 2021) and Karolinska University Hospital in Sweden (February 2020-September 2021), we conducted a...
Article
Long-term oral corticosteroid (OCS) treatment for severe asthma is known to cause significant adverse effects, but knowledge on effects of lower exposures in general asthma populations is limited. We aimed to explore this in a nationwide Danish asthma population. Users of asthma medication aged 18–45 were identified in the Danish nationwide registe...
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It is known that younger patients treated with antipsychotics are at increased risk of metabolic events; however, it is unknown how this risk varies according to ethnicity, the class of antipsychotic and the specific product used, and by age group. We conducted a multinational sequence symmetry study in Asian populations (Hong Kong, Japan, Korea, T...
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Importance Statin use is common in older persons. Given uncertainties in ongoing benefit, changes in health status, and shifting goals of care and preferences, statin discontinuation may be considered in some older persons, although there is currently little evidence to guide this decision. Objective To evaluate the association between statin disc...
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Objectives Emerging evidence supports that PR interval prolongation is associated with increased mortality. However, most previous studies have limited confounder control, and clinical impact in a population of acute ill patients is unknown. The aim of this study was to investigate whether 1-year all-cause mortality was increased in patients presen...
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Purpose: Evidence is insufficient to infer whether topical calcineurin inhibitors (TCIs; tacrolimus and pimecrolimus) cause malignancy. The study objective was to estimate the long-term risk of skin cancer and lymphoma associated with topical TCI use in adults and children, separately. Patients and methods: A cohort study in Denmark, Sweden, UK,...
Chapter
This chapter focuses on the description of key commonalities and distinctions across encounter databases, illustrated with selected examples and supplemented by references to more comprehensive resources in the literature. It includes a dedicated discussion of the considerations faced by researchers when evaluating the appropriateness of a specific...
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Background: The Danish National Patient Registry is a major resource for Danish epidemiology. Only a few studies have been conducted to check the validity of the reporting of systemic anticancer treatments. In this study, we assessed this validity for a range of cancer types over a long period of time. Patients and methods: We extracted systemic...
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Background Lipid levels in blood have decreased considerably during the past decades in the general population partly due to use of statins. This study aims to investigate the trends in lipid levels between 2001 and 2018 in a statin-free population from primary health care, overall and by sex and age. Methods In a cohort of 634,119 patients from g...
Article
Oral corticosteroids (OCS) are used in asthma management but can cause serious adverse effects. We aimed to investigate the usage trends in a nationwide asthma cohort in Denmark from 1999-2018. Using national registers, we identified young adults (18-45 years) with two or more asthma drug collections within 12 months since the age of 15 years as in...
Article
Background: Studies have suggested increased risks of childhood leukaemia after prenatal exposure to antibiotics, particularly nitrofurantoin. However, these findings may be related to the underlying maternal infection. This multinational study aimed to investigate the association between prenatal nitrofurantoin exposure and childhood leukaemia wh...
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Purpose Concomitant use of vitamin K antagonists (VKA) and statins is frequent in cardiovascular patients. However, clinical guidelines on this drug combination are divergent. Therefore, we performed a systematic review to evaluate the effect of statin initiation on coagulation among VKA users. Methods Following the PRISMA guidelines, we applied t...
Article
Background: Immunosuppression may worsen SARS-CoV-2 infection. We conducted a nationwide cohort study of the effect of exposure to immunosuppressants on the prognosis of SARS-CoV-2 infection in Denmark. Methods: We identified all SARS-CoV-2 test-positive patients from February to October 2020 and linked health care data from nationwide registers...
Article
Purpose The antihypertensive agent hydrochlorothiazide has recently been linked to increased risk of skin cancer. We sought to describe the impact of the dissemination of these findings on the use of hydrochlorothiazide and health care utilization among antihypertensive users in Denmark. Methods In this nationwide observational study, we performed...
Article
Purpose To examine use of sedating medications around the time of nursing home admission in Denmark. Methods We conducted a register-based drug utilization study, describing patterns of commonly used medications with sedative effects leading up to and after nursing home admission using data from 94 Danish nursing homes between 2015 and 2017. Resu...
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Objective: To evaluate if proton pump inhibitor (PPI) treatment reduces the risk of upper gastrointestinal bleeding (UGIB) in patients with atrial fibrillation (AF) treated with non-vitamin K antagonist oral anticoagulants (NOACs). Design: We used a common protocol, common data model approach to conduct a cohort study including patients with AF...
Article
Background Recent evidence has established a beneficial effect of systemic corticosteroids for treatment of moderate-to-severe COVID-19. Objective To determine if inhaled corticosteroid use is associated with COVID-19 outcomes. Methods In a nationwide cohort of hospitalized SARS-CoV-2 test-positive individuals in Denmark, we estimated the 30-day...
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Background: Case-control studies based on pharmaco-epidemiological databases typically use decision rules to determine exposure status from information on dates of prescription redemptions, although this induces misclassification. The reverse Waiting Time Distribution has been suggested as a likelihood based model to estimate the latent exposure s...
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Aims/hypothesisSodium–glucose cotransporter 2 inhibitors (SGLT2Is) may reduce nephrolithiasis risk by increasing urine flow. We aimed to investigate whether initiation of SGLT2I was associated with reduced nephrolithiasis risk.Methods We conducted an active-comparator new-user cohort study using the Danish health registries in the period 11 Novembe...
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Purpose: To evaluate the potential of Danish prescription registries to capture aspirin and non-aspirin non-steroidal anti-inflammatory drug (NSAID) use and to quantitatively evaluate the magnitude of bias from misclassification of true NSAID and aspirin use as apparent non-use in drug outcome studies. Patients and methods: In a population-based...
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Randomised controlled trials have shown a neutral or even unfavourable risk–benefit balance of aspirin for primary prevention of cardiovascular events. Using Danish nationwide registries, we investigated aspirin use and associated risks during the past two decades (1998–2018). We linked individual patient data on repeated aspirin redemptions with r...
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Aims To assess persistence and adherence to non-vitamin K antagonist oral anticoagulant (NOAC) treatment in patients with atrial fibrillation (AF) in five Western European healthcare settings. Methods and results We conducted a multi-country observational cohort study, including 559 445 AF patients initiating NOAC therapy from Stockholm (Sweden),...
Article
Background: Hypnotic use in children and adolescents is controversial. Objective: To describe use of hypnotic drugs (melatonin, z-drugs and sedating antihistamines) among 5-24-year-old Scandinavians during 2012 to 2018. Methods: Aggregate-level data was obtained from public data sources in Sweden, Norway and Denmark. We calculated annual preva...
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Cancer is an important cause of childhood mortality, yet the etiology is largely unknown. A combination of pre- and postnatal factors is thought to be implicated, including maternal medication use. We aimed to provide 1) a systematic review of peer-reviewed publications on associations between maternal medication use and childhood cancer with a foc...
Article
Purpose: Hydrochlorothiazide (HCTZ) use has been linked to skin cancer in northern European countries. We assessed the association between HCTZ exposure and risk of malignant melanoma (MM) and keratinocyte carcinoma (KC) in a European Mediterranean population. Methods: Two parallel nested case-control studies were conducted in Spain using two el...
Article
Background: Hydrochlorothiazide (HCTZ), a common diuretic known to be photosensitizing and previously associated with non-melanoma skin cancer, was recently reported to be associated with two melanoma subtypes, nodular and lentigo, among residents of Denmark. Our goal was to examine whether Danish findings could be replicated in a US cohort, using...
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Objective: To assess rates of cardiovascular and haemostatic events in the first 28 days after vaccination with the Oxford-AstraZeneca vaccine ChAdOx1-S in Denmark and Norway and to compare them with rates observed in the general populations. Design: Population based cohort study. Setting: Nationwide healthcare registers in Denmark and Norway....
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Importance: Spontaneous (nontraumatic) intracerebral hemorrhage (ICH) is the most severe complication of antithrombotic drug use. Objectives: To estimate the strength of association between use of antithrombotic drugs and risk of ICH and to examine major changes in the incidence of ICH in the general population. Design, setting, and participant...
Article
Background Individuals admitted to hospital for COVID-19 might have persisting symptoms (so-called long COVID) and delayed complications after discharge. However, little is known regarding the risk for those not admitted to hospital. We therefore examined prescription drug and health-care use after SARS-CoV-2 infection not requiring hospital admiss...
Article
Background: Hypertension is a leading cause of morbidity in Ghana. However, there is insufficient data on the prevalence and quality of antihypertensive therapy. Objectives: To describe the prevalence of use and quality of antihypertensive therapy. Methods: A cross-sectional study design was used to analyze the 2015 Ghana National Health Insur...
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Background Studies have shown poor post-discharge implementation by the general practitioner of changes made to patients’ medication during admission. Objective To assess the feasibility of conducting telephone conferences delivering information about changes in older patients’ medications from hospital to general practitioners. Setting Two departm...
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Purpose To describe the use of tramadol and other analgesics in Denmark focusing on the impact of media attention (June and December 2017) and regulatory actions (September 2017 and January 2018) on the use of tramadol. Methods Using nationwide registries, we identified all adults who filled a prescription for tramadol and other analgesics from 20...
Article
Knowledge on utilization patterns of non‐insulin antidiabetic drugs in childhood and youth is limited. Therefore, we conducted a population‐based drug utilization study using publicly available aggregate data on use of non‐insulin antidiabetics from 2010‐2019 in Scandinavia (Denmark, Norway, and Sweden) in individuals aged up to 24 years. For each...
Preprint
Full-text available
Background Studies have shown poor post-discharge implementation of changes made to patients’ medication during admission by the general practitioner. Objective To assess the feasibility of conducting telephone conferences to deliver information about changes in older patients’ medications from the hospital to the general practitioners. Setting Dan...
Article
Background: Anticancer treatments near the end of a patient's life should generally be avoided, as it leaves the patient with no significant anticancer effect but increases the risk of severe side effects. We described the pattern of all end-of-life anticancer treatment in a population of Danish cancer patients. Methods: Using the Danish nationa...
Article
(Acta Obstet Gynecol Scand. 2020;99:399–405) Severe maternal morbidity associated with childbirth has increased in the last 30 years in the United States. A score to predict risk for maternal morbidity would be useful to help place high-risk women at better-equipped facilities and also address some confounding factors in research. The Obstetric Com...
Article
Background/objectives: Successful deprescribing requires insight into patients' thoughts about deprescribing. We described attitudes towards deprescribing in a large sample of geriatric patients and nursing home residents. Design: Interview-based questionnaire study. Setting: Denmark. Participants: Geriatric inpatients (n = 44), geriatric ou...
Article
Importance Parkinson disease (PD) is a common neurodegenerative disease. A treatment that prevents or delays development of PD is a critical unmet need. Terazosin and closely related drugs were recently discovered to enhance glycolysis and reduce PD progression in animal models and human clinical databases. Objective To determine whether use of te...
Article
Incretin‐based therapies ‐ GLP‐1 receptor agonists and DPP‐4 inhibitors ‐ have been hypothesized to exert beneficial effects on COVID‐19 outcomes due to anti‐inflammatory properties. In this population‐based cohort study, we retrieved data from nationwide registries on all individuals diagnosed with SARS‐CoV‐2 infection up to November 1, 2020. For...