Change of initial oral antidiabetic therapy in type 2 diabetic patients

Objective To explore the ‘real-life' therapy of type 2 diabetes mellitus with oral antidiabetic drugs (OADs). Methods From the PHARMO Record Linkage System comprising linked drug dispensing and clinical laboratory data from approximately 2.5 million individuals in the Netherlands, among others,...

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Published in:Pharmacy world and science 2009-12, Vol.31 (6), p.622-626
Main Authors: Plat, Arian, Penning-van Beest, Fernie, Kessabi, Sophia, Groot, Martijn, Herings, Ron
Format: Article
Language:English
Subjects:
Administration, Oral
Adult
Aged
Biomarkers - blood
Changes
Diabetes
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - drug therapy
Drug Administration Schedule
Drug therapy
Drug Therapy, Combination
Drug Utilization
Female
Glycated Hemoglobin A - metabolism
Humans
Hypoglycemic Agents - administration & dosage
Internal Medicine
Male
Medical Records Systems, Computerized
Medicine
Medicine & Public Health
Middle Aged
Netherlands
Pharmacy
Practice Patterns, Physicians
Prescription drugs
Retrospective Studies
Short Research Report
Time Factors
Treatment Outcome
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Summary:Objective To explore the ‘real-life' therapy of type 2 diabetes mellitus with oral antidiabetic drugs (OADs). Methods From the PHARMO Record Linkage System comprising linked drug dispensing and clinical laboratory data from approximately 2.5 million individuals in the Netherlands, among others, new users of OADs were identified in the period 1999-2004. New users, aged 30 years and older, without insulin use before cohort entry date and with at least one year follow-up were included. We determined per initial therapy patient characteristics and first therapy change. Results Overall 35,514 patients were included. Metformin and sulfonylureas (SU) were the most frequent initial therapy. Patients on thiazolidinedione (TZD) monotherapy had lower percentages baseline HbA1c ≥ 7% compared to patients on metformin and SU. The proportion of patients still on initial therapy after one year ranged from 46% (TZDs) to around 60% (SU). Among patients starting on monotherapy, add-on (15-20%) and discontinuation (16-25%) of therapy occurred most frequently. In patients starting on combination therapy, a switch occurred in 30% of the patients. Conclusion In more than 40% of the patients a change in initial OAD-therapy is already observed in the first year of therapy. Maintaining patients on initial therapy remains a challenge.
ISSN:0928-1231
2210-7703
1573-739X
2210-7711
DOI:10.1007/s11096-009-9321-0