Disparity in Guideline-Based Antidiabetic Drugs Prescribing for Type 2 Diabetes Patients in Primary Healthcare Facilities Across China, 2017-2019.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY Pharmacoepidemiology and Drug Safety Pub Date : 2024-08-01 DOI:10.1002/pds.5882

Mengyuan Fu, Zhiwen Gong, Yuezhen Zhu, Can Li, Huangqianyu Li, Luwen Shi, Xiaodong Guan

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Abstract

Purpose: The purpose of this study is to evaluate the pattern, appropriateness, and cost of antidiabetic drugs prescribed for patients with Type 2 diabetes at primary healthcare facilities (PHFs) in China.

Methods: We collected outpatient-visit prescriptions from 363 PHFs in 31 cities covering eastern, central, and western regions of China. The visits of adult patients with Type 2 diabetes diagnosis were collected and classified the antidiabetic medication pattern of each patient use as recommended or non-recommended according to Chinese guidelines. We then calculated the proportion of guideline-recommended patterns and the average monthly cost for each pattern, overall and by region.

Results: Of 33 519 prescriptions for Type 2 diabetes, most (73.9%) were for guideline-recommended antidiabetic treatments. The proportion of guideline-recommended prescriptions varied by region (eastern [75.9%], central [87.5%], and western [59.7%]). Metformin monotherapy was the most common guideline-recommended treatment in all three regions (eastern [20.1%], central [28.0%], and western [24.6%]). The most common non-guideline-recommended treatments were monotherapy of insulin (eastern [16.5%], central [5.1%], and western [25.7%]) and traditional Chinese antidiabetic medicines (eastern [5.6%], central [5.7%], and western [11.1%]). The average monthly costs were lower for guideline-recommended treatments compared to non-recommended treatments in all regions (eastern [13.6 ± 15.4 USD vs. 28.1 ± 22.0 USD], central [9.8 ± 10.9 USD vs. 28.7 ± 19.4 USD], and western [17.9 ± 21.4 USD vs. 30.3 ± 23.6 USD]).

Conclusions: The majority of patients with Type 2 diabetes received guideline-recommended antidiabetic medications at PHFs in China, with only half of the prescriptions containing guideline-recommended metformin. Utilization of guideline-recommended therapies differed across regions. Tailored interventions to promote evidence-based antidiabetic prescribing are urgently needed, especially in the undeveloped western region.

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2017-2019年全国基层医疗机构2型糖尿病患者基于指南的抗糖尿病药物处方差异。

目的：本研究旨在评估中国基层医疗机构（PHF）为 2 型糖尿病患者开具的抗糖尿病药物的模式、适宜性和成本：我们收集了中国东部、中部和西部地区 31 个城市 363 家基层医疗卫生机构的门诊处方。我们收集了确诊为 2 型糖尿病的成年患者的门诊处方，并根据中国指南将每位患者的抗糖尿病药物使用模式分为推荐和非推荐两种。然后，我们计算了指南推荐模式的比例以及每种模式的月平均费用，包括总体费用和各地区费用：在 33 519 份 2 型糖尿病处方中，大部分（73.9%）是指南推荐的抗糖尿病治疗方法。指南推荐处方的比例因地区而异（东部[75.9%]、中部[87.5%]和西部[59.7%]）。二甲双胍单一疗法是所有三个地区最常见的指南推荐疗法（东部[20.1%]、中部[28.0%]和西部[24.6%]）。最常见的非指南推荐疗法是胰岛素单药治疗（东部[16.5%]、中部[5.1%]和西部[25.7%]）和中药抗糖尿病药物治疗（东部[5.6%]、中部[5.7%]和西部[11.1%]）。在所有地区，指南推荐疗法的月平均费用均低于非推荐疗法（东部[13.6 ± 15.4 美元 vs. 28.1 ± 22.0 美元]、中部[9.8 ± 10.9 美元 vs. 28.7 ± 19.4 美元]和西部[17.9 ± 21.4 美元 vs. 30.3 ± 23.6 美元]）：结论：在中国，大多数2型糖尿病患者在公共卫生机构接受了指南推荐的抗糖尿病药物治疗，只有一半的处方含有指南推荐的二甲双胍。不同地区对指南推荐疗法的使用情况也不尽相同。亟需采取有针对性的干预措施，促进以循证医学为基础的抗糖尿病处方，尤其是在不发达的西部地区。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.