Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Diabetes Res Clin Pract. 2012 Jun;96(3):319-25. doi: 10.1016/j.diabres.2012.01.012. Epub 2012 Feb 3.
This study examined the rates of discontinuation of Oral Hypoglycemic Agents (OHAs) in diabetes patients, and to evaluate the associations between discontinuation of OHAs, socioeconomic status and the number of comorbidities.
A cohort study from January 2004 to June 2007 was conducted and followed up through December 2007. We included all primary care clinics in one large territories of Hong Kong involving 28,773 Chinese diabetes patients. Multivariate regression analyses controlled for age, gender, payment status (fee-payers vs. fee waivers; fee-waivers represented those less able to pay for consultation fees and were regarded as having lower socioeconomic status), service type delivered by the clinics, district of residence, visit type (new vs. follow-up), the number of comorbidities and the drug class (sulphonylureas vs. biguanide vs. combination therapy).
9.9% discontinued their medications within 180 days of their prescriptions. Fee waivers (adjusted odds ratio [AOR] for fee payers=0.81, 95% C.I. 0.73-0.89, p<0.001) and the absence of comorbidities (AOR for ≥one morbidity=0.59-0.62, p<0.001) were associated with medication discontinuation.
Diabetes patients with lower ability to pay and without comorbidities were significantly associated with OHAs discontinuation. They should be the target groups for medication counseling programmes.
本研究旨在调查糖尿病患者中断口服降糖药（OHAs）治疗的比例，并评估中断 OHAs 治疗与社会经济地位和共病数量之间的关系。
进行了一项从 2004 年 1 月至 2007 年 6 月的队列研究，并随访至 2007 年 12 月。我们纳入了香港一个大型地区所有初级保健诊所的 28773 名中国糖尿病患者。多变量回归分析控制了年龄、性别、支付状态（付费者与免费者；免费者代表那些无力支付咨询费，被认为社会经济地位较低）、诊所提供的服务类型、居住地区、就诊类型（新就诊与随诊）、共病数量和药物类别（磺脲类与二甲双胍与联合治疗）。
9.9%的患者在处方后 180 天内停止服用药物。免费者（付费者的调整优势比 [AOR] =0.81，95%置信区间 [CI] 0.73-0.89，p<0.001）和无共病（≥一种共病的 AOR=0.59-0.62，p<0.001）与药物停药相关。
支付能力较低和无共病的糖尿病患者与 OHAs 停药显著相关。他们应该是药物咨询计划的目标人群。
