Cassidi C. McDaniel , Wei-Hsuan Lo-Ciganic , Chiahung Chou
{"title":"2 型糖尿病治疗惰性后的糖尿病相关并发症、血糖水平和医疗保健利用率结果","authors":"Cassidi C. McDaniel , Wei-Hsuan Lo-Ciganic , Chiahung Chou","doi":"10.1016/j.pcd.2023.12.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><p>To assess diabetes-related complications, glycemic<span> levels, and healthcare utilization 12 months after exposure to therapeutic inertia among patients with type 2 diabetes mellitus (T2D).</span></p></div><div><h3>Methods</h3><p><span><span>This retrospective cohort study analyzed data from the OneFlorida </span>Clinical Research<span><span> Consortium (electronic health records from Florida practices/clinics). The cohort included adult patients (≥18 years old) with T2D who had an HbA1c≥7.0% (53 mmol/mol) recorded from January 1, 2014-September 30, 2019. Therapeutic inertia (exposed vs. not exposed) was evaluated during the six months following HbA1c≥7.0% (53 mmol/mol). The outcomes assessed during the 12-month follow-up period included diabetes-related complications (continuous </span>Diabetes Complications and Severity Index (DCSI)), glycemic levels (continuous follow-up </span></span>HbA1c lab), and healthcare utilization counts. We analyzed data using multivariable regression models, adjusting for covariates.</p></div><div><h3>Results</h3><p>The cohort included 26,881 patients with T2D (58.94% White race, 49.72% female, and mean age of 58.82 (SD=13.09)). After adjusting for covariates, therapeutic inertia exposure was associated with lower DCSI (estimate=−0.14 (SE=0.03), p < 0.001), higher follow-up HbA1c (estimate=0.14 (SE=0.04), p < 0.001), and lower rates of ambulatory visits (rate ratio=0.79, 95% CI=0.75–0.82).</p></div><div><h3>Conclusions</h3><p>Findings communicate the clinical practice implications and public health implications for combating therapeutic inertia in diabetes care.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 2","pages":"Pages 188-195"},"PeriodicalIF":2.6000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diabetes-related complications, glycemic levels, and healthcare utilization outcomes after therapeutic inertia in type 2 diabetes mellitus\",\"authors\":\"Cassidi C. McDaniel , Wei-Hsuan Lo-Ciganic , Chiahung Chou\",\"doi\":\"10.1016/j.pcd.2023.12.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><p>To assess diabetes-related complications, glycemic<span> levels, and healthcare utilization 12 months after exposure to therapeutic inertia among patients with type 2 diabetes mellitus (T2D).</span></p></div><div><h3>Methods</h3><p><span><span>This retrospective cohort study analyzed data from the OneFlorida </span>Clinical Research<span><span> Consortium (electronic health records from Florida practices/clinics). The cohort included adult patients (≥18 years old) with T2D who had an HbA1c≥7.0% (53 mmol/mol) recorded from January 1, 2014-September 30, 2019. Therapeutic inertia (exposed vs. not exposed) was evaluated during the six months following HbA1c≥7.0% (53 mmol/mol). The outcomes assessed during the 12-month follow-up period included diabetes-related complications (continuous </span>Diabetes Complications and Severity Index (DCSI)), glycemic levels (continuous follow-up </span></span>HbA1c lab), and healthcare utilization counts. We analyzed data using multivariable regression models, adjusting for covariates.</p></div><div><h3>Results</h3><p>The cohort included 26,881 patients with T2D (58.94% White race, 49.72% female, and mean age of 58.82 (SD=13.09)). After adjusting for covariates, therapeutic inertia exposure was associated with lower DCSI (estimate=−0.14 (SE=0.03), p < 0.001), higher follow-up HbA1c (estimate=0.14 (SE=0.04), p < 0.001), and lower rates of ambulatory visits (rate ratio=0.79, 95% CI=0.75–0.82).</p></div><div><h3>Conclusions</h3><p>Findings communicate the clinical practice implications and public health implications for combating therapeutic inertia in diabetes care.</p></div>\",\"PeriodicalId\":48997,\"journal\":{\"name\":\"Primary Care Diabetes\",\"volume\":\"18 2\",\"pages\":\"Pages 188-195\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Primary Care Diabetes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S175199182300222X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Primary Care Diabetes","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S175199182300222X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Diabetes-related complications, glycemic levels, and healthcare utilization outcomes after therapeutic inertia in type 2 diabetes mellitus
Aims
To assess diabetes-related complications, glycemic levels, and healthcare utilization 12 months after exposure to therapeutic inertia among patients with type 2 diabetes mellitus (T2D).
Methods
This retrospective cohort study analyzed data from the OneFlorida Clinical Research Consortium (electronic health records from Florida practices/clinics). The cohort included adult patients (≥18 years old) with T2D who had an HbA1c≥7.0% (53 mmol/mol) recorded from January 1, 2014-September 30, 2019. Therapeutic inertia (exposed vs. not exposed) was evaluated during the six months following HbA1c≥7.0% (53 mmol/mol). The outcomes assessed during the 12-month follow-up period included diabetes-related complications (continuous Diabetes Complications and Severity Index (DCSI)), glycemic levels (continuous follow-up HbA1c lab), and healthcare utilization counts. We analyzed data using multivariable regression models, adjusting for covariates.
Results
The cohort included 26,881 patients with T2D (58.94% White race, 49.72% female, and mean age of 58.82 (SD=13.09)). After adjusting for covariates, therapeutic inertia exposure was associated with lower DCSI (estimate=−0.14 (SE=0.03), p < 0.001), higher follow-up HbA1c (estimate=0.14 (SE=0.04), p < 0.001), and lower rates of ambulatory visits (rate ratio=0.79, 95% CI=0.75–0.82).
Conclusions
Findings communicate the clinical practice implications and public health implications for combating therapeutic inertia in diabetes care.
期刊介绍：
The journal publishes original research articles and high quality reviews in the fields of clinical care, diabetes education, nutrition, health services, psychosocial research and epidemiology and other areas as far as is relevant for diabetology in a primary-care setting. The purpose of the journal is to encourage interdisciplinary research and discussion between all those who are involved in primary diabetes care on an international level. The Journal also publishes news and articles concerning the policies and activities of Primary Care Diabetes Europe and reflects the society''s aim of improving the care for people with diabetes mellitus within the primary-care setting.
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