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印度糖尿病治疗的药物处方模式与成本分析:一项内分泌科实践的审计

Drug Prescription Patterns and Cost Analysis of Diabetes Therapy in India: Audit of an Endocrine Practice.

作者信息

Singla Rajiv, Bindra Jatin, Singla Ankush, Gupta Yashdeep, Kalra Sanjay

机构信息

Department of Endocrinology, Kalpavriksh Healthcare, Dwarka, India.

Department of Health Informatics, Kalpavriksh Healthcare, Dwarka, India.

出版信息

Indian J Endocrinol Metab. 2019 Jan-Feb;23(1):40-45. doi: 10.4103/ijem.IJEM_646_18.

Abstract

AIMS

The aim of this study was to analyze the current trend in the use of antidiabetes as well as other drugs for comorbidities along the duration of diabetes. The study also aimed to analyze the direct drug cost to patients.

SETTINGS AND DESIGN

Retrospective cross-sectional study.

SUBJECTS AND METHODS

Data captured in clinic electronic medical records of an endocrine practice was analyzed.

STATISTICAL ANALYSIS USED

Data was analyzed descriptively using machine learning codes on python platform.

RESULTS

Records of 489 people who attended the clinic during the 6-month period were retrieved. Data of 403 people with diabetes were analyzed after exclusion of incomplete data. Use of antidiabetic drug increased from 1.44 (0.78) [mean (standard deviation)] in people with a duration of diabetes <5 years to 3.18 (1.05) in people with 20+ years of diabetes. The mean number of antidiabetic drug usage seems to plateau at 15 years of diabetes. About 46% of people with 20+ years of diabetes required insulin therapy. Prescription patterns involving a combination of different drug classes in patients were also analyzed. The cost of diabetes therapy increases linearly along the duration of diabetes.

CONCLUSION

This study provides valuable insights on temporal prescription patterns of antidiabetic drugs from an endocrine practice. Metformin remains the most preferred drug across the entire duration of diabetes. Dipeptidyl peptidase-4 inhibitors seem to be fast catching up with sulfonylureas as a second-line treatment after metformin. After 20 years or more of diabetes duration, 46% people would require insulin for glycemic control.

摘要

目的

本研究旨在分析糖尿病病程中抗糖尿病药物以及用于治疗合并症的其他药物的使用现状趋势。该研究还旨在分析患者的直接药物成本。

设置与设计

回顾性横断面研究。

研究对象与方法

分析了一家内分泌诊所临床电子病历中记录的数据。

所用统计分析方法

在Python平台上使用机器学习代码对数据进行描述性分析。

结果

检索到了6个月期间到该诊所就诊的489人的记录。排除不完整数据后,对403名糖尿病患者的数据进行了分析。糖尿病病程<5年的患者抗糖尿病药物的使用量从1.44(0.78)[均值(标准差)]增加到糖尿病病程≥20年的患者的3.18(1.05)。抗糖尿病药物的平均使用量在糖尿病病程15年时似乎趋于平稳。糖尿病病程≥20年的患者中约46%需要胰岛素治疗。还分析了患者中涉及不同药物类别组合的处方模式。糖尿病治疗成本随糖尿病病程呈线性增加。

结论

本研究为内分泌诊所抗糖尿病药物的时间处方模式提供了有价值的见解。二甲双胍在糖尿病的整个病程中仍然是最常用的药物。二肽基肽酶-4抑制剂似乎正在迅速赶上磺脲类药物,成为二甲双胍后的二线治疗药物。糖尿病病程达到20年或更长时间后,46%的患者需要胰岛素来控制血糖。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a05d/6446683/e0529df2dfb1/IJEM-23-40-g001.jpg

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