PMID- 27547410
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160822
LR  - 20220311
IS  - 2052-4897 (Print)
IS  - 2052-4897 (Electronic)
IS  - 2052-4897 (Linking)
VI  - 4
IP  - 1
DP  - 2016
TI  - Medication usage, treatment intensification, and medical cost in patients with 
      type 2 diabetes: a retrospective database study.
PG  - e000189
LID - 10.1136/bmjdrc-2015-000189 [doi]
LID - e000189
AB  - OBJECTIVE: The goal of this study was to describe medication usage patterns in 
      patients with type 2 diabetes mellitus (T2DM) initiating treatment with 
      non-insulin antidiabetic drugs (NIADs), basal insulin, or prandial/mixed insulin 
      using real-world data. RESEARCH DESIGN AND METHODS: A retrospective analysis 
      using the Truven Health MarketScan Research Databases was conducted to identify 
      adults (>/=18 years) with T2DM from 2006 to 2012. Patients were categorized into 
      four cohorts based on diabetes treatment. Cohort 1 (n=597 664) consisted of newly 
      diagnosed patients who did not receive any treatment, cohort 2 (n=342 511) 
      included NIAD initiators, cohort 3 (n=99 578) included basal insulin initiators, 
      and cohort 4 (n=62 876) included prandial/mixed insulin initiators. Patients 
      transitioned out of a cohort once they met the criteria for the next one. 
      RESULTS: Patients in cohort 2 were younger (56.2 years, SD+/-12.1) than patients in 
      cohorts 1, 3, and 4 (58 years, SD+/-0.75). Metformin was the most commonly 
      prescribed drug in cohort 2 patients. Basal insulin usage decreased from 71% in 
      year 1 to 47% in year 4, in cohort 3 patients. Approximately one-third of these 
      patients switched to prandial/mixed insulin each year. In cohort 4, the usage of 
      prandial/mixed insulin decreased to 61% by year 4. Use of basal insulin and NIAD 
      remained common in this group. Mean glycosylated hemoglobin (HbA1c) values 
      decreased by  approximately 1% for each of the treatment cohorts following treatment initiation 
      and remained stable during follow-up. All-cause and diabetes-related medical 
      costs were highest for patients in cohorts 3 and 4. CONCLUSIONS: Overall, our 
      findings demonstrate that treatment intensification was low in all study cohorts 
      despite elevated HbA1c levels during preindex and follow-up period.
FAU - Bonafede, Machaon
AU  - Bonafede M
AD  - Truven Health Analytics , Cambridge, Massachusetts , USA.
FAU - Chandran, Arthi
AU  - Chandran A
AD  - Health Economics and Outcomes Research , Becton Dickinson , Franklin Lakes, New 
      Jersey , USA.
FAU - DiMario, Stefan
AU  - DiMario S
AD  - Health Economics and Outcomes Research , Becton Dickinson , Franklin Lakes, New 
      Jersey , USA.
FAU - Saltiel-Berzin, Rita
AU  - Saltiel-Berzin R
AD  - Medical Affairs , Becton Dickinson , Franklin Lakes, New Jersey , USA.
FAU - Saliu, Drilon
AU  - Saliu D
AD  - Medical Affairs , Becton Dickinson , Franklin Lakes, New Jersey , USA.
LA  - eng
PT  - Journal Article
DEP - 20160718
PL  - England
TA  - BMJ Open Diabetes Res Care
JT  - BMJ open diabetes research & care
JID - 101641391
PMC - PMC4964196
OTO - NOTNLM
OT  - Adherence to Medications
OT  - Glycemic Control
OT  - Type 2 Diabetes
EDAT- 2016/08/23 06:00
MHDA- 2016/08/23 06:01
PMCR- 2016/07/18
CRDT- 2016/08/23 06:00
PHST- 2015/12/22 00:00 [received]
PHST- 2016/06/06 00:00 [revised]
PHST- 2016/06/27 00:00 [accepted]
PHST- 2016/08/23 06:00 [entrez]
PHST- 2016/08/23 06:00 [pubmed]
PHST- 2016/08/23 06:01 [medline]
PHST- 2016/07/18 00:00 [pmc-release]
AID - bmjdrc-2015-000189 [pii]
AID - 10.1136/bmjdrc-2015-000189 [doi]
PST - epublish
SO  - BMJ Open Diabetes Res Care. 2016 Jul 18;4(1):e000189. doi: 
      10.1136/bmjdrc-2015-000189. eCollection 2016.