Initial therapy, regimen change, and persistence in a spanish cohort of newly treated type 2 diabetes patients: A retrospective, observational study using real-world data

Moreno-Juste, A. ; Poblador-Plou, B. ; Aza-Pascual-Salcedo, M. ; González-Rubio, F. ; Malo, S. (Universidad de Zaragoza) ; Librero López, J. ; Pico-Soler, V. ; Gimenez Labrador, E. ; Mucherino, S. ; Orlando, V. ; Menditto, E. ; Prados-Torres, A. ; Gimeno-Miguel, A.

Resumen: The World Health Organization considers the non-adherence to medication a significant issue with global impact, especially in chronic conditions such as type 2 diabetes. We aim to study antidiabetic treatment initiation, add-on, treatment switching, and medication persistence. We conducted an observational study on 4247 individuals initiating antidiabetic treatment between 2013 and 2014 in the EpiChron Cohort (Spain). We used Cox regression models to estimate the likelihood of non-persistence after a one-year follow-up, expressed as hazard ratios (HRs). Metformin was the most frequently used first-line antidiabetic (80% of cases); combination treatment was the second most common treatment in adults aged 40–79 years, while dipeptidyl peptidase-4 inhibitors were the second most common in individuals in their 80s and over, and in patients with renal disease. Individuals initiated on metformin were less likely to present addition and switching events compared with any other antidiabetic. Almost 70% of individuals initiated on monotherapy were persistent. Subjects aged 40 and over (HR 0.53–0.63), living in rural (HR 0.79) or more deprived areas (HR 0.77–0.82), or receiving polypharmacy (HR 0.84), were less likely to show discontinuation. Our findings could help identify the population at risk of discontinuation, and offer them closer monitoring for proper integrated management to improve prognosis and health outcomes.

Idioma: Inglés

DOI: 10.3390/ijerph17103742

Año: 2020

Publicado en: International Journal of Environmental Research and Public Health 17, 10 (2020), 3742 [16 pp]
ISSN: 1661-7827

Factor impacto JCR: 3.39 (2020)

Categ. JCR: PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH rank: 41 / 176 = 0.233 (2020) - Q1 - T1
Categ. JCR: ENVIRONMENTAL SCIENCES rank: 118 / 273 = 0.432 (2020) - Q2 - T2
Categ. JCR: PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH rank: 68 / 203 = 0.335 (2020) - Q2 - T2

Factor impacto SCIMAGO: 0.747 - Health, Toxicology and Mutagenesis (Q2) - Public Health, Environmental and Occupational Health (Q2) - Pollution (Q2)

Financiación: info:eu-repo/grantAgreement/ES/DGA-FEDER/B01-20R
Financiación: info:eu-repo/grantAgreement/ES/DGA-FEDER/Construyendo Europa desde Aragón
Financiación: info:eu-repo/grantAgreement/EUR/INTERREG-V-POCTEFA-2014-2020

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Medic.Prevent.Salud Públ. (Dpto. Microb.Ped.Radio.Sal.Pú.)