The New Zealand Ministry of Health holds several national administrative data collections which can be used for pharmacoepidemiological research. These include the Mortality Collection (registered deaths and stillbirths), the National Minimum Dataset (hospital discharges), the New Zealand Cancer Registry (all cancers, except non-melanoma skin cancers), the National Maternity Collection (publicly funded maternity and new-born services), the National Immunisation Register (immunisation records of all children born since 2005), the Laboratory Claims Collection (types of laboratory tests undertaken, but not the results), and the Pharmaceutical Collection (claims by community-based pharmacists for the dispensing of prescription medicines and devices which are publicly funded). The Ministry has also developed a Virtual Diabetes Register. Patient records in the data collections are indexed to a unique identifier, the National Health Index (NHI), which enables the linkage of patient-level health and pharmaceutical dispensing data, along with demographic data held in the NHI Collection.
This presentation will provide examples of national studies which used data from these collections to explore medicine and medical device safety and utilisation issues which were of direct clinical interest at the time – including disparities in insulin pump utilisation, the use of prescription medicines during pregnancy, off-label use of proton pump inhibitors (PPIs) in infants, the extent of co-prescribing of contraindicated and use-with-caution medicines among simvastatin users, whether patterns of use of long-acting bronchodilators in people with chronic obstructive pulmonary disease (COPD) are consistent with international COPD treatment guidelines, and various safety concerns related to PPI use and to simvastatin dose.