Banting & Best Diabetes Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Can J Diabetes. 2017 Jun;41(3):253-258. doi: 10.1016/j.jcjd.2016.12.001. Epub 2017 Mar 17.
The objective of the study was to describe the demographic and clinical characteristics of MedsCheck Diabetes (MCD) recipients in Ontario between program launch on September 1, 2010, and March 31, 2014.
This cohort study leveraged linked administrative claims data. Trends in MCD claims and recipient characteristics were examined.
A total of 406,694 Ontarians (45.8% women) received an MCD, representing approximately half of all Ontarians with diabetes. Recipients were more likely to be <66 years of age (54.6%), live in an urban centre (94.6%) and be native to Canada (81.0%). A total of 13,587 MCD follow ups were completed (4.1% of MCD recipients ≥66 years of age and 2.7% of MCD recipients <66 years of age). MCD recipients ≥66 years of age had received a mean of 11 unique prescription medications in the previous year, prior to receiving an MCD, and 12.9% had had high medication costs ($4000+) in the previous year. Metformin was dispensed to 76.4% of recipients, insulin to 20.1% and insulin secretagogues to 36.2%. The most common medication classes used by MCD recipients, other than antihyperglycemics, were antihypertensives (89.5%), antilipid therapies (83.8%), diuretics (52.1%), antibiotics (38.2%) and gastroprotective agents (34.9%). They were also taking high-risk medications, including narcotics (25.4%), anticoagulants (23.3%), nonsteroidal anti-inflammatory drugs (NSAIDs) (21.5%), benzodiazepines (15.5%) and glyburide (15.8%).
Over the first 3.5 years of the program, approximately half of Ontarians with diabetes received an MCD. Follow-up assessments were low (2.7% to 4.1% of the population). Ongoing evaluation of the program is required to ensure that continuity of care is being provided to this population.
本研究旨在描述 2010 年 9 月 1 日至 2014 年 3 月 31 日期间安大略省 MedsCheck Diabetes（MCD）受助人的人口统计学和临床特征。
本队列研究利用了关联的行政索赔数据。研究了 MCD 索赔和受助人特征的趋势。
共有 406694 名安大略省人（45.8%为女性）接受了 MCD，约占所有糖尿病患者的一半。受助人更可能年龄在 66 岁以下（54.6%），居住在城市中心（94.6%），且原籍为加拿大（81.0%）。共有 13587 次 MCD 随访完成（≥66 岁的 MCD 受助人的 4.1%和 <66 岁的 MCD 受助人的 2.7%）。≥66 岁的 MCD 受助人在接受 MCD 之前的前一年共接受了 11 种不同的处方药，且 12.9%的人在前一年的药物费用超过 4000 加元（高费用）。二甲双胍的处方率为 76.4%，胰岛素为 20.1%，胰岛素促分泌素为 36.2%。MCD 受助人除降糖药外最常用的药物类别为降压药（89.5%）、降脂治疗药（83.8%）、利尿剂（52.1%）、抗生素（38.2%）和胃保护剂（34.9%）。他们还服用了高危药物，包括麻醉剂（25.4%）、抗凝剂（23.3%）、非甾体抗炎药（NSAIDs）（21.5%）、苯二氮䓬类（15.5%）和格列吡嗪（15.8%）。
在该计划的头 3.5 年期间，大约一半的安大略省糖尿病患者接受了 MCD。后续评估率较低（占总人口的 2.7%至 4.1%）。需要对该计划进行持续评估，以确保为这一人群提供持续的护理。
