Department of Pharmacoeconomic and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Daru. 2023 Dec;31(2):259-266. doi: 10.1007/s40199-023-00481-z. Epub 2023 Oct 17.
Diabetes Mellitus (DM) is a prominent health care issue worldwide. One of the most prevalent comorbidities of DM is cardiovascular disease (CVD). The objective of this study was to assess the utilization patterns of cardiovascular medications in patients with DM in Iran from 2013 to 2017.
This retrospective cross-sectional study was undertaken using prescription claims data from 2013 to 2017 in Iran. Epidemiological data elements used in this study were obtained from the Global Burden of Disease (GBD) 2019 study. In addition, data on total medication sales were obtained from the national regulatory authority database. The data on medication utilization were analyzed according to the Anatomical Therapeutic Chemical Classification (ATC) /Defined Daily Doses (DDD) international system.
Based on the findings, Acetylsalicylic acid was the mainstay of treatment with a utilization rate of 191.7 DDD/ patient/ year in 2017, followed by Atorvastatin with 170.0 and Losartan with 115.1. Although there was an increasing trend in the utilization rate of the medications, the rate of Atenolol and Enalapril was constantly declining during the 2013-17 period. On the other hand, Valsartan and Metoprolol were attracting attention. Almost all medication utilization rates increased from the 30-39 age group up to the 80 + age group. Females had a higher utilization rate in each age group during the whole study period.
The present study reflects that medication utilization patterns were rational, according to the standard treatment guidelines. Utilization patterns of medications that are recommended for both prevention and treatment of CVD in diabetes were observed to be the highest. Implementation of further policies is needed to minimize cardiovascular complications of diabetes.
糖尿病（DM）是全球一个突出的医疗保健问题。DM 最常见的合并症之一是心血管疾病（CVD）。本研究的目的是评估 2013 年至 2017 年伊朗 DM 患者心血管药物的使用模式。
本回顾性横断面研究使用了 2013 年至 2017 年伊朗的处方索赔数据。本研究使用的流行病学数据元素来自 2019 年全球疾病负担（GBD）研究。此外，药物销售总量数据来自国家监管机构数据库。药物使用数据根据解剖治疗化学分类（ATC）/定义日剂量（DDD）国际系统进行分析。
根据研究结果，2017 年乙酰水杨酸是治疗的主要药物，使用率为 191.7 DDD/患者/年，其次是阿托伐他汀（170.0）和氯沙坦（115.1）。尽管药物使用率呈上升趋势，但在 2013-17 年期间，阿替洛尔和依那普利的使用率持续下降。另一方面，缬沙坦和美托洛尔引起了关注。几乎所有药物的使用率都从 30-39 岁年龄组上升到 80+岁年龄组。在整个研究期间，女性在每个年龄组的使用率都更高。
本研究反映了药物使用模式是合理的，符合标准治疗指南。观察到用于预防和治疗糖尿病 CVD 的药物的使用率最高。需要实施进一步的政策，以最大限度地减少糖尿病的心血管并发症。
