A population-based analysis of antidiabetic medications in four Canadian provinces: Secular trends and prescribing patterns.

Autor: Secrest MH; Centre for Clinical Epidemiology, Lady Davis Research Institute, Jewish General Hospital, McGill University, Montreal, Quebec, Canada., Azoulay L; Centre for Clinical Epidemiology, Lady Davis Research Institute, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.; Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada., Dahl M; Department of Community Health Sciences, Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada., Clemens KK; Department of Medicine, and Epidemiology and Biostatistics, Western University, London, Ontario, Canada.; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.; Lawson Health Research Institute, London, Ontario, Canada., Durand M; Internal Medicine Service, Centre Hospitalier Universitaire de Montreal (CHUM), Montreal, Quebec, Canada., Hu N; The Health Quality Council, Saskatoon, Saskatchewan, Canada., Targownik L; Department of Community Health Sciences, Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada.; Section of Gastroenterology, Division of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada., Turin TC; Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada., Dormuth CR; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada., Filion KB; Centre for Clinical Epidemiology, Lady Davis Research Institute, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.; Department of Medicine, McGill University, Montreal, Quebec, Canada.
Jazyk: angličtina
Zdroj: Pharmacoepidemiology and drug safety [Pharmacoepidemiol Drug Saf] 2020 Jan; Vol. 29 Suppl 1, pp. 86-92. Date of Electronic Publication: 2019 Aug 28.
DOI: 10.1002/pds.4878
Abstrakt: Purpose: To use the Canadian Network for Observational Drug Effect Studies (CNODES) to describe drug utilization of antidiabetic medications in four Canadian provinces.
Methods: With the use of data from CNODES, we constructed cohorts of patients with type 2 diabetes in four Canadian provinces (Manitoba, Ontario, Quebec, and Saskatchewan) who received their first-ever prescription for a noninsulin antidiabetic medication during the study period, defined as the earliest date of data availability in each province (range: 1993-1998) to the latest date of the data extraction in each province (range: 2013-2014). Prescriptions rates were calculated for all prescriptions by class and described over time.
Results: Across provinces, we identified 650 830 patients who initiated antidiabetic medications during the study period. In most provinces, the overall prescription rate of antidiabetic medications increased during the last two decades. Metformin particularly increased in popularity, surpassing sulfonylureas in all provinces as the most widely prescribed antidiabetic medication by the early 2000s. Thiazolidinediones grew in popularity from the onset of their availability until 2006 to 2007, at which point they rapidly declined. Dipeptidyl peptidase-4 inhibitors saw substantial growth in several provinces following their addition to provincial formularies in 2008 to 2012, while glucagon-like peptide-1 agonists experienced modest growth. Insulin prescription rates remained constant or steadily increased over the last two decades.
Conclusions: CNODES can be used for cross-jurisdictional drug utilization studies. In Canada, trends in antidiabetic medication prescriptions followed changing guidelines reflecting up-to-date knowledge of drug effectiveness and safety.
(© 2019 John Wiley & Sons, Ltd.)
Databáze: MEDLINE
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