The question of the inclusion of periods of interruptions and periods unobservable has been studied as part of medico-administrative databases. However, the specificity of the health insurance databases justify the realization of dedicated methodological research. A thorough knowledge of the purpose of these data, how they collect and restitution is an essential prerequisite to carry out this work. One type of scheme cohort exposed/unexposed led to the formulation of a finding on the basis of the comparison between the exposure groups. However, this traditional approach has the major drawback of neglecting the changing nature of drug exposure, and therefore fails to take into account any changes or interruptions doses. Approaches to take into account the time dependent variables were developed. These allow to take into account any interruptions. However, as part of study on health databases, sometimes we do not have the status in relation to the exhibition on the entire monitoring period. This is for example the case during hospitalization. The bias generated by the failure to take account of these periods ("non measurable time bias") can be problematic when a long exposure and chronic disorders require hospitalization.
Study Type
OBSERVATIONAL
Enrollment
171,861
Exposition to at least one drug belonging to the following classes during the last 12 months before index date : * Benzodiazepine derivatives (N05BA) * Benzodiazepine derivatives (N05CD) * Benzodiazepine related drugs (N05CF)
Exposition to at least one drug belonging to the following classes during the last 12 months before index date : * Antipsychotics (N05A) * Antiepileptics with the exception of clonazepam (N03) * Drugs used for alcohol dependance (N07BB) * Drugs used for opioids dependance (N07BC)
Medical consultation without prescription of any drugs of interest
* Gender * Birthdate * Department of residence * City of residence * Vital status (month and date of death) * Affiliation to Universal Health Coverage * Number of chronic long-term illness, medical diagnostic or pathology (CIM 10 code), onset and end dates * Drugs reimbursements (Date of care onset, drugs identification code, number of box delivered) * Data collected from medicalisation program of information system and private and public home care structures * Medical consultations, medical acts ( Common Classification of Medical Acts nomenclature)
Comparison of mortality from all causes in the 3 groups as assessed by clinical data collected
Four approaches will be used : * intergroup comparison * Time influence with cox model * Use of markovian models * Inclusion of "non observable periods" with inobservable and observable death models
Time frame: through the end of study (12 months)
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