未满足的社会需求与 2 型糖尿病患者使用二甲双胍之间的关联。
Association of Unmet Social Needs With Metformin Use Among Patients With Type 2 Diabetes.
机构信息
Department of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC.
出版信息
Diabetes Care. 2023 Nov 1;46(11):2044-2049. doi: 10.2337/dc23-0448.
OBJECTIVE
To evaluate the relationship between social needs and metformin use among adults with type 2 diabetes (T2D).
RESEARCH DESIGN AND METHODS
In a prospective cohort study of adults with T2D (n = 722), we linked electronic health record (EHR) and Surescripts (Surescripts, LLC) prescription network data to abstract data on patient-reported social needs and to calculate metformin adherence based on expected refill frequency using a proportion of days covered methodology.
RESULTS
After adjusting for demographics and clinical complexity, two or more social needs (-0.046; 95% CI -0.089, 0.003), being uninsured (-0.052; 95% CI -0.095, -0.009) and while adjusting for other needs, being without housing (-0.069; 95% CI -0.121, -0.018) and lack of access to medicine/health care (-0.058; 95% CI -0.115, -0.000) were associated with lower use.
CONCLUSIONS
We found that overall social need burden and specific needs, particularly housing and health care access, were associated with clinically significant reductions in metformin adherence among patients with T2D.
目的
评估 2 型糖尿病（T2D）成年人的社会需求与二甲双胍使用之间的关系。
研究设计与方法
在一项对 T2D 成年人（n=722）的前瞻性队列研究中，我们将电子病历（EHR）和 Surescripts（Surescripts，LLC）处方网络数据与患者报告的社会需求摘要数据相关联，并使用覆盖天数比例法计算基于预期补充频率的二甲双胍依从性。
结果
在调整了人口统计学和临床复杂性因素后，存在两个或更多的社会需求（-0.046；95%置信区间-0.089，0.003）、没有保险（-0.052；95%置信区间-0.095，-0.009），而在调整了其他需求后，没有住房（-0.069；95%置信区间-0.121，-0.018）和缺乏药物/医疗保健的机会（-0.058；95%置信区间-0.115，-0.000）与较低的使用量相关。
结论
我们发现，总体社会需求负担和特定需求，特别是住房和医疗保健机会，与 T2D 患者的二甲双胍依从性显著降低有关。
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