与收入、同居和居住地区有关的抗糖尿病药物使用差异:一项瑞典全国性队列研究。

IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Paulina Jonéus, Björn Pasternak, Ingvild Odsbu, Carolyn E Cesta, Rino Bellocco, Ylva Trolle Lagerros, Laura Pazzagli
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引用次数: 0

摘要

背景:2型糖尿病(T2D)患者抗糖尿病药物依从性差可能导致发病率和死亡率增加。与不依从性相关的社会经济和人口因素主要是通过横断面研究确定的。探讨抗糖尿病药物依从性与收入、同居和居住地区的关系。方法:对2006年至2022年间居住在瑞典并开始抗糖尿病治疗的t2dm患者进行基于登记的队列研究。混合调整和竞争事件通过处理的逆概率和审查加权来解释。暴露因素包括可支配收入、社会收入支持、同居状况和居住地区。结果是从治疗开始的第一年抗糖尿病药物依从性和治疗中断的12个月和60个月。结果:本研究纳入594 918例T2D患者。低可支配收入(调整后OR: 1.18, 95% CI:(1.14至1.21))、社会收入支持(1.09,(1.05至1.14))、居住在大城市(1.28,(1.24至1.31))和同居(1.09,(1.06至1.11))与不坚持(覆盖天数比例≤0.2)相关,而与高坚持(覆盖天数比例≤0.8)相关。一贯地,治疗中断与社会收入支持有关(12个月的相对风险比:1.10,(1.06至1.14),60个月的相对风险比为1.02(1.00至1.05)),居住在大城市(1.13,(1.12至1.14);1.08,(1.07 ~ 1.08))和低收入(1.05,(1.03 ~ 1.07);1.01,(1.00至1.02))。结论:低收入水平、同居和居住在大城市与抗糖尿病药物不依从性和治疗中断风险相关。结果强调需要有针对性的干预措施,旨在提高患者和医疗保健系统水平的治疗依从性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Differential use of antidiabetic medication related to income, cohabitation and area of residence: a Swedish nationwide cohort study.

Background: Poor adherence to antidiabetic medication in individuals with type 2 diabetes (T2D) may lead to increased risk of morbidity and mortality. Socioeconomic and demographic factors associated with non-adherence have been mainly identified via cross-sectional studies. To investigate the association between antidiabetic medication adherence and income, cohabitation and area of residence.

Methods: Register-based cohort study of individuals with T2D living in Sweden and initiating antidiabetic treatment between 2006 and 2022. Confounding adjustment and competing events were accounted for via inverse probability of treatment and censoring weighting. Exposures were disposable income, social income support, cohabitation status and area of residence. Outcomes were antidiabetic medication adherence during the first year from treatment initiation and treatment interruption at 12 and 60 months.

Results: This study included 594 918 individuals with T2D. Low disposable income (adjusted OR: 1.18, 95% CI: (1.14 to 1.21)), social income support (1.09, (1.05 to 1.14)), living in large cities (1.28, (1.24 to 1.31)) and cohabitation (1.09, (1.06 to 1.11)) were associated with non-adherence (proportion of days covered ≤0.2), as compared with high adherence (proportion of days covered >0.8). Consistently, treatment interruption was associated with social income support (relative risk ratio at 12 months: 1.10, (1.06 to 1.14) and at 60 months 1.02 (1.00 to 1.05)), living in large cities (1.13, (1.12 to 1.14); 1.08, (1.07 to 1.08)) and low income (1.05, (1.03 to 1.07); 1.01, (1.00 to 1.02)).

Conclusions: Low income levels, cohabitation and living in large cities were associated with non-adherence to antidiabetic medication and risk of treatment interruption. The results highlight the need for targeted interventions aiming at improving adherence to treatments both at patient and healthcare system levels.

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来源期刊
Journal of Epidemiology and Community Health
Journal of Epidemiology and Community Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
11.10
自引率
0.00%
发文量
100
审稿时长
3-6 weeks
期刊介绍: The Journal of Epidemiology and Community Health is a leading international journal devoted to publication of original research and reviews covering applied, methodological and theoretical issues with emphasis on studies using multidisciplinary or integrative approaches. The journal aims to improve epidemiological knowledge and ultimately health worldwide.
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