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 |
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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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