Pharmacoepidemiological research and the linking of electronic healthcare databases available in the Italian region of Lombardy

Objectives. To evaluate the usefulness of linking databases with the purpose of obtaining reliable evidence for pharmacoepidemiological research, we used databases available in the Italian region of Lombardy in attemt to replicate well-enstablished associations. Methods. We investigate the effect of: (a) fluoroquinolones on the risk of tendinitis; (b) persistence with ormone replacement therap (HRT) on the risks of cardiovascular disease, malignant neoplasms and bone fractures; (c) low persistence with anti-osteoporotic treatment on the risk of bone fracture; (d) initial antihypertensive drug therapy on the risk of treatment discontinuation. Results. As expected, we observed that: patients treated with fluoroquinolones are at the increased risk of developing tendon disorders; (b) women who received HRT for long periods are at decreased risk of developing cardiovascular desease, colorectal cancer and bone fractures, and at the increased risk of breast cancer; (c) women showing low persistence with bisphosphonates for treatment of osteoporosis are at6 increased risk of bone fracture; (d) patiens beginnig therapy with the newer classes of antihypertensives exhibit better stay-on treatment rates than those starting with diuretics or beta-blockers. Conclusions. Electronic databases may supply reliable evidence for pharmacoepidemiological research, including real - world drug utilisation patterns, detection of adverse drug events, and evaluation of drug effectiveness in actual clinical practice.