糖尿病的多重用药:一项全国性的、基于药物的观察性研究

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Etienne Larger , Laure Alexandre-Heymann , Simon Pilet , Thomas Raoul , Lucas Perray , Milka Maravic
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引用次数: 2

摘要

目的根据治疗的时间顺序建立糖尿病的分类。第二个目的是描述在全国范围内糖尿病患者队列中为糖尿病和相关疾病开的药物的多样性。患者和方法lrx是一个门诊全国范围的药物分配数据库。它由法国1万家零售药店组成。我们开发了一种算法,以找出2018年7月至2019年6月期间接受糖尿病治疗的患者数量,并对多年来的糖尿病类型和药物分配顺序进行分类,包括控制糖尿病本身的治疗和相关疾病的药物。结果研究的原始数据为230万患者,对应于法国大陆推断的390万患者。7%的人被归类为1型糖尿病,86%的人被归类为2型糖尿病(T2D), 0.5%的人被归类为胰岛素治疗的妊娠糖尿病,还有6%的人未被归类。在T2D患者中,二甲双胍是最常用的降糖药物,其次是DPP4抑制剂和磺脲类药物。主要处方药物类别为降脂药和降压药。值得注意的是,大约三分之一的患者接受了神经精神药物治疗,40%的患者接受了质子泵抑制剂治疗。我们对治疗依从性也有一个公正的看法,低于50%。结论该算法可用于监测血糖控制策略及合并症的变化。我们的研究结果强调了糖尿病患者的多重用药负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Polypharmacy in diabetes: A nation-wide, pharmacy-based, observational study

Aim

The aim of the present study was to build a classification of diabetes according to the time-sequence of treatment. A second aim was to describe the diversity of drugs prescribed for diabetes and associated conditions in a nation-wide cohort of patients with diabetes.

Patients and method

LRx is an outpatient care nation-wide medication dispense database. It consists of a panel of 10,000 retail pharmacies in France. We developed an algorithm to find out the number of patients treated for diabetes from July 2018 to June 2019 and to classify diabetes types and the sequence of drugs dispense over the years, including treatments for the control of diabetes itself and drugs for associated conditions.

Results

A raw number of 2.3 million patients was studied, corresponding to an extrapolated 3.9 million patients in mainland France. Seven percent were classified as having Type 1 Diabetes, 86% Type 2 Diabetes (T2D), 0.5% insulin-treated gestational diabetes, and 6% remained unclassified. In subjects with T2D, metformin was the most frequently prescribed glucose lowering drug, followed by DPP4 inhibitors and sulfonylureas. Main coprescribed medication classes were lipid-modifying agents and antihypertensive agents. Of note, about a third of the patients received neuropsychiatric drugs and 40% a proton-pump inhibitor. We also had an unbiased view of compliance to treatment, that was below 50%.

Conclusion

The algorithm we built could be used to monitor changes of strategies to control blood glucose and comorbidities. Our findings highlight the burden of polypharmacy in patients with diabetes.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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