PMID- 29938343
OWN - NLM
STAT- MEDLINE
DCOM- 20190614
LR  - 20190614
IS  - 1432-1041 (Electronic)
IS  - 0031-6970 (Linking)
VI  - 74
IP  - 10
DP  - 2018 Oct
TI  - Interrogation of a longitudinal, national pharmacy claims dataset to explore 
      factors that predict the need for add-on therapy in older and socioeconomically 
      disadvantaged Australians with type 2 diabetes mellitus patients (T2DM).
PG  - 1327-1332
LID - 10.1007/s00228-018-2506-5 [doi]
AB  - PURPOSE: The management of type 2 diabetes mellitus (T2DM) is complex. The aim of 
      this work is to explore factors that predict the need for add-on therapy in 
      patients with T2DM in the community. METHODS: We accessed longitudinal, pharmacy 
      payment claim records from the national Pharmaceutical Benefits Scheme (PBS) 
      (Subsidises costs of medicines: government pays difference between patient 
      co-payments, lower in concessional patients, and additional cost of drug.) for 
      the period January 2006 to September 2014 (EREC/MI3127) from a 10% random sample 
      of the Australian population validated to be representative of the population by 
      the Australian Bureau of Statistics (ABS). Likely, T2DM patients were identified 
      as those having been dispensed a single anti-hyperglycaemic drug (monotherapy). 
      The time taken and possible factors that might lead to the addition of a second 
      therapy were examined. An examination was made of trends in the co-prescription 
      of either antihypertensive or anti-hyperlipidaemic agents in relation to the time 
      (+/- 3 years) of initiating an anti-hyperglycaemic agent. RESULTS: Most (83%) 
      presumed T2DM patients were initiated with metformin. The average time until the 
      second agent was added was 4.8 years (95% CI 4.7-4.9). Satisfactory adherence, 
      age, male gender, initiating therapy after 2012 and initiating with a 
      sulphonylurea drug all were significant risks for add-on therapy. There was no 
      overall trend in the initiation of antihypertensive and/or anti-hyperlipidaemic 
      agents with respect to the time of anti-hyperglycaemic initiation. CONCLUSION: 
      The usefulness of a longitudinal dataset of pharmacy-claim records is 
      demonstrated. Over half of all older and socioeconmically disadvantaged T2DM 
      patients captured in this longitudinal claims database will be prescribed a 
      second anti-hyperglycaemic agent within 5 years of their first drug therapy. 
      Several factors can predict the risk of prescription of add-on therapy, and these 
      should be considered when prescribing medications to treat T2DM.
FAU - Kumar, S S
AU  - Kumar SS
AD  - Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, 
      Sydney, NSW, Australia.
AD  - School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia.
FAU - McManus, H
AU  - McManus H
AD  - Prospection Pty Ltd, Sydney, NSW, Australia.
FAU - Radovich, T
AU  - Radovich T
AD  - Prospection Pty Ltd, Sydney, NSW, Australia.
FAU - Greenfield, J R
AU  - Greenfield JR
AD  - Division of Diabetes and Metabolism, Garvan Institute, Sydney, NSW, Australia.
AD  - St Vincent's Clinical School, UNSW Australia, Sydney, NSW, Australia.
FAU - Viardot, A
AU  - Viardot A
AD  - Division of Diabetes and Metabolism, Garvan Institute, Sydney, NSW, Australia.
AD  - St Vincent's Clinical School, UNSW Australia, Sydney, NSW, Australia.
FAU - Williams, K M
AU  - Williams KM
AD  - Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, 
      Sydney, NSW, Australia.
AD  - School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia.
FAU - Cronin, P
AU  - Cronin P
AD  - Prospection Pty Ltd, Sydney, NSW, Australia.
FAU - Day, R O
AU  - Day RO
AUID- ORCID: 0000-0002-6045-6937
AD  - Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, 
      Sydney, NSW, Australia. r.day@unsw.edu.au.
AD  - School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia. 
      r.day@unsw.edu.au.
AD  - St Vincent's Clinical School, UNSW Australia, Sydney, NSW, Australia. 
      r.day@unsw.edu.au.
LA  - eng
GR  - LP0990670/Australian Research Council/
GR  - 568612/National Health and Medical Research Council/
PT  - Journal Article
DEP - 20180624
PL  - Germany
TA  - Eur J Clin Pharmacol
JT  - European journal of clinical pharmacology
JID - 1256165
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Sulfonylurea Compounds)
RN  - 9100L32L2N (Metformin)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Australia
MH  - Databases, Factual
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/*administration & dosage
MH  - Longitudinal Studies
MH  - Male
MH  - Medication Adherence
MH  - Metformin/*administration & dosage
MH  - Middle Aged
MH  - Sex Factors
MH  - Social Class
MH  - Socioeconomic Factors
MH  - Sulfonylurea Compounds/*administration & dosage
MH  - Time Factors
MH  - Vulnerable Populations
OTO - NOTNLM
OT  - Add-on therapy
OT  - Longitudinal data
OT  - Pharmacy claims database
OT  - Type 2 diabetes
EDAT- 2018/06/26 06:00
MHDA- 2019/06/15 06:00
CRDT- 2018/06/26 06:00
PHST- 2017/11/28 00:00 [received]
PHST- 2018/06/14 00:00 [accepted]
PHST- 2018/06/26 06:00 [pubmed]
PHST- 2019/06/15 06:00 [medline]
PHST- 2018/06/26 06:00 [entrez]
AID - 10.1007/s00228-018-2506-5 [pii]
AID - 10.1007/s00228-018-2506-5 [doi]
PST - ppublish
SO  - Eur J Clin Pharmacol. 2018 Oct;74(10):1327-1332. doi: 10.1007/s00228-018-2506-5. 
      Epub 2018 Jun 24.