Regional differences in antihyperglycemic medication are not explained by individual socioeconomic status, regional deprivation, and regional health care services. Observational results from the German DIAB-CORE consortium

Autor: Karl-Heinz Jöckel, Werner Maier, Heiner Claessen, Teresa Tamayo, Lars Eric Kroll, Saskia Hartwig, M Schunk, Alexander Kluttig, Christina Bächle, Christa Meisinger, Susanne Moebus, Sabine Schipf, Ina-Maria Rückert-Eheberg, Andrea Icks, Henry Völzke, Ute Linnenkamp, Rolf Holle
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Medical Doctors
Health Care Providers
Medizin
lcsh:Medicine
Blood Pressure
Regional Medical Programs
Vascular Medicine
Geographical locations
Cohort Studies
0302 clinical medicine
Endocrinology
Germany
Health care
Prevalence
Medicine and Health Sciences
Medicine
030212 general & internal medicine
Medical Personnel
lcsh:Science
education.field_of_study
Multidisciplinary
Pharmaceutics
Health Services
Middle Aged
Type 2 Diabetes
Europe
Professions
Hypertension
symbols
Population study
Female
Cohort study
Research Article
Endocrine Disorders
Population
Cardiology
030209 endocrinology & metabolism
Social class
03 medical and health sciences
symbols.namesake
Drug Therapy
Physicians
Diabetes Mellitus
Humans
Hypoglycemic Agents
Poisson regression
ddc:610
European Union
education
Socioeconomic status
Life Style
Aged
Models
Statistical
business.industry
lcsh:R
Health Care
Diabetes Mellitus
Type 2
Social Class
Socioeconomic Factors
Metabolic Disorders
People and Places
Observational study
Population Groupings
lcsh:Q
business
Demography
Zdroj: PLoS ONE, Vol 13, Iss 1, p e0191559 (2018)
PLoS ONE
PLoS ONE 13:e0191559 (2018)
ISSN: 1932-6203
Popis: Aims This population-based study sought to extend knowledge on factors explaining regional differences in type 2 diabetes mellitus medication patterns in Germany. Methods Individual baseline and follow-up data from four regional population-based German cohort studies (SHIP [northeast], CARLA [east], HNR [west], KORA [south]) conducted between 1997 and 2010 were pooled and merged with both data on regional deprivation and regional health care services. To analyze regional differences in any or newer anti-hyperglycemic medication, medication prevalence ratios (PRs) were estimated using multivariable Poisson regression models with a robust error variance adjusted gradually for individual and regional variables. Results The study population consisted of 1,437 people aged 45 to 74 years at baseline, (corresponding to 49 to 83 years at follow-up) with self-reported type 2 diabetes. The prevalence of receiving any anti-hyperglycemic medication was 16% higher in KORA (PR 1.16 [1.08 +/- 1.25]), 10% higher in CARLA (1.10 [1.01 +/- 1.18]), and 7% higher in SHIP (PR 1.07 [1.00 +/- 1.15]) than in HNR. The prevalence of receiving newer anti-hyperglycemic medication was 49% higher in KORA (1.49 [1.09 +/- 2.05]), 41% higher in CARLA (1.41 [1.02 +/- 1.96]) and 1% higher in SHIP (1.01 [0.72 +/- 1.41]) than in HNR, respectively. After gradual adjustment for individual variables, regional deprivation and health care services, the effects only changed slightly. Conclusions Neither comprehensive individual factors including socioeconomic status nor regional deprivation or indicators of regional health care services were able to sufficiently explain regional differences in anti-hyperglycemic treatment in Germany. To understand the underlying causes, further research is needed.
Databáze: OpenAIRE
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