使用澳大利亚行政药物数据估计糖尿病药物治疗的发病率和患病率。

Estimates of drug treated diabetes incidence and prevalence using Australian administrative pharmaceutical data.

机构信息

Department of Public Health, La Trobe University, Bundoora, Victoria, Australia.

Monash Centre for Occupational and Environmental Health, Monash University, Victoria, Australia.

出版信息

Int J Popul Data Sci. 2021 May 10;6(1):1398. doi: 10.23889/ijpds.v6i1.1398.

DOI:10.23889/ijpds.v6i1.1398

PMID:34007898

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8121372/

Abstract

INTRODUCTION

The incidence and prevalence of diabetes within a population are important public health metrics. Pharmaceutical administrative data may offer a resource that can contribute to quantifying these measures using the recorded signals derived from the drugs used to treat people with diabetes.

OBJECTIVE

To estimate the longitudinal incidence and prevalence of drug treated (DT) diabetes in Australia utilising an Australian Pharmaceutical Benefits Scheme (PBS) dataset and compare estimates with community survey data for all diabetes reported in the Australian National Health Survey (NHS).

METHODS

Persons with DT diabetes were identified within the PBS dataset using assigned Anatomic Therapeutic Chemical codes for 'Drugs used in diabetes'. Prevalent persons with DT diabetes were determined by a single annual treatment, and incident cases from the earliest treatment with diabetes medications. Counts were aggregated by age group and utilised Australian national census data as a denominator to calculate diabetes disease frequencies for the period 2004-14. Comparison of PBS prevalence data was made with NHS surveys over equivalent years.

RESULTS

The age adjusted incidence of DT diabetes was 3.4/1000 in 2006 and increased to 3.8/1000 in 2011 and 5.1/1000 in 2014. Age adjusted prevalence of DT diabetes in Australia also rose from 26.7/1000 in 2006 to 32.1/1000 in 2011 and 42.1/1000 in 2014. DT diabetes prevalence estimates correlated with NHS estimates of self-reported diabetes prevalence across age groups and in 2014 was r = 0.987. However, PBS estimates of DT diabetes prevalence generally underestimated NHS values of self-reported diabetes in older age groups with mean percentage differences of -22% to -3%. In contrast, PBS data captured more younger persons with diabetes in comparison to NHS data. These differences were then used to adjust DT diabetes incidence rates to provide age specific estimates that could potentially reflect diabetes incidence estimates acquired by community survey.

CONCLUSIONS

PBS data representing dispensed medications prescribed to persons with diabetes offers a perspective for the assessment of diabetes incidence and prevalence. PBS derived DT diabetes prevalence estimates correlate well with community survey estimates of self-reported diabetes, but underestimate NHS data in older age groups. Calibrated DT incidence estimates may potentially reflect community survey derived diabetes incidence estimates and may offer a method for longitudinal monitoring.

摘要

简介

人群中糖尿病的发病率和患病率是重要的公共卫生指标。药物管理数据库可能是一种资源，可以利用从治疗糖尿病患者的药物中获得的记录信号来量化这些指标。

目的

利用澳大利亚药物福利计划（PBS）数据集估计澳大利亚药物治疗（DT）糖尿病的纵向发病率和患病率，并将估计值与澳大利亚国家健康调查（NHS）报告的所有糖尿病的社区调查数据进行比较。

方法

利用 PBS 数据集为“糖尿病用药”分配的解剖治疗化学（ATC）代码确定 DT 糖尿病患者。通过每年一次的治疗确定 DT 糖尿病的现患患者，通过最早使用糖尿病药物的治疗确定新发病例。根据年龄组汇总计数，并利用澳大利亚全国人口普查数据作为分母，计算 2004-14 年期间的糖尿病疾病频率。将 PBS 患病率数据与 NHS 同期调查进行比较。

结果

调整年龄后的 DT 糖尿病发病率在 2006 年为 3.4/1000，在 2011 年增加到 3.8/1000，在 2014 年增加到 5.1/1000。澳大利亚 DT 糖尿病的年龄调整患病率也从 2006 年的 26.7/1000上升到 2011 年的 32.1/1000和 2014 年的 42.1/1000。DT 糖尿病患病率估计值与 NHS 调查报告的各年龄组的自我报告糖尿病患病率相关，2014 年的相关系数为 0.987。然而，PBS 对 DT 糖尿病患病率的估计值通常低于 NHS 对老年人群中自我报告糖尿病患病率的估计值，平均百分比差异为-22%至-3%。相比之下，PBS 数据比 NHS 数据更能反映出年轻人群中的糖尿病患者。然后利用这些差异对 DT 糖尿病发病率进行调整，提供年龄特异性估计值，这些估计值可能反映了通过社区调查获得的糖尿病发病率估计值。

结论

代表为糖尿病患者开具的处方药物的 PBS 数据为评估糖尿病发病率和患病率提供了一个视角。PBS 衍生的 DT 糖尿病患病率估计值与社区调查报告的自我报告糖尿病相关性较好，但在老年人群中低估了 NHS 数据。经过校准的 DT 发病率估计值可能反映了社区调查得出的糖尿病发病率估计值，并且可能提供了一种纵向监测的方法。