Kostev Karel, Rockel Timo, Jacob Louis
1 QuintilesIMS, Frankfurt, Germany.
2 Faculty of Medicine, University of Paris 5, Paris, France.
J Diabetes Sci Technol. 2018 Jan;12(1):136-139. doi: 10.1177/1932296817710477. Epub 2017 May 25.
The aim of this study was to analyze prescription patterns and disease control in patients with type 2 diabetes mellitus (T2DM) in nursing home and home care settings in Germany.
The present study is based on data from the Disease Analyzer database (QuintilesIMS). Patients with an initial diagnosis of T2DM and documented HbA1c values between January 2011 and December 2015 were included in the analysis. The index date corresponded to the last documented HbA1c value. Patients in nursing homes were matched (1:1) with patients living at home based on age, gender, and dementia diagnosis. The first outcome of the study was the share of use of several antidiabetic drugs in the two different settings. The second outcome was the mean HbA1c value and the proportion of patients with HbA1c values lower than 7% in the two different groups.
In this study, 4925 individuals lived in nursing homes and 4925 individuals lived at home. The mean age was 80.7 years (SD = 7.7). Prescription patterns differed significantly between nursing home and home care settings: insulin (57.9% vs 41.1%), metformin (46.6% vs 60.5%), sulfonylurea (24.9% vs 34.2%), DPP4 inhibitors (13.4% vs 19.8%), and other antihyperglycemic drugs (7.8% vs 12.1%). In contrast, mean HbA1c values (nursing home: 7.2%; home: 7.2%) and the share of patients with Hb1Ac values lower than 7% (nursing home: 49.1%; home: 50.9%) did not differ significantly between the two groups.
Overall, the differences in prescription patterns between nursing homes and home care were not associated with significant differences in the management of T2DM.
本研究旨在分析德国养老院和居家护理环境中2型糖尿病（T2DM）患者的处方模式和疾病控制情况。
本研究基于疾病分析器数据库（昆泰艾美仕市场研究公司）的数据。纳入分析的患者为2011年1月至2015年12月期间初次诊断为T2DM且有记录的糖化血红蛋白（HbA1c）值的患者。索引日期对应最后记录的HbA1c值。养老院患者根据年龄、性别和痴呆诊断与居家患者进行1:1匹配。本研究的第一个结果是两种不同环境中几种抗糖尿病药物的使用份额。第二个结果是两组中糖化血红蛋白的平均水平以及糖化血红蛋白水平低于7%的患者比例。
本研究中，4925人居住在养老院，4925人居家生活。平均年龄为80.7岁（标准差=7.7）。养老院和居家护理环境中的处方模式存在显著差异：胰岛素（57.9%对41.1%）、二甲双胍（46.6%对60.5%）、磺脲类药物（24.9%对34.2%）、二肽基肽酶-4（DPP4）抑制剂（13.4%对19.8%）以及其他降糖药物（7.8%对12.1%）。相比之下，两组之间糖化血红蛋白的平均水平（养老院：7.2%；居家：7.2%）以及糖化血红蛋白水平低于7%的患者比例（养老院：49.1%；居家：50.9%）没有显著差异。
总体而言，养老院和居家护理之间的处方模式差异与2型糖尿病管理的显著差异无关。
