Pharmacoepidemiological profiles of oral hypoglycemic agents among 28,773 Chinese patients with diabetes

Diabetes Res Clin Pract. 2012 Jun;96(3):319-25. doi: 10.1016/j.diabres.2012.01.012. Epub 2012 Feb 3.

Abstract

Aims: This study examined the rates of discontinuation of Oral Hypoglycemic Agents (OHAs) in diabetes patients, and to evaluate the associations between discontinuation of OHAs, socioeconomic status and the number of comorbidities.

Methods: A cohort study from January 2004 to June 2007 was conducted and followed up through December 2007. We included all primary care clinics in one large territories of Hong Kong involving 28,773 Chinese diabetes patients. Multivariate regression analyses controlled for age, gender, payment status (fee-payers vs. fee waivers; fee-waivers represented those less able to pay for consultation fees and were regarded as having lower socioeconomic status), service type delivered by the clinics, district of residence, visit type (new vs. follow-up), the number of comorbidities and the drug class (sulphonylureas vs. biguanide vs. combination therapy).

Results: 9.9% discontinued their medications within 180 days of their prescriptions. Fee waivers (adjusted odds ratio [AOR] for fee payers=0.81, 95% C.I. 0.73-0.89, p<0.001) and the absence of comorbidities (AOR for ≥one morbidity=0.59-0.62, p<0.001) were associated with medication discontinuation.

Conclusions: Diabetes patients with lower ability to pay and without comorbidities were significantly associated with OHAs discontinuation. They should be the target groups for medication counseling programmes.

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People / statistics & numerical data*
  • Cohort Studies
  • Databases, Factual
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / drug effects
  • Glycated Hemoglobin / metabolism*
  • Hong Kong / epidemiology
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / economics
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Patient Selection
  • Pharmacoepidemiology
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Socioeconomic Factors
  • Withholding Treatment / economics
  • Withholding Treatment / statistics & numerical data*

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • hemoglobin A1c protein, human