Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.
International Research Center for Medicinal Administration, Peking University, Beijing, China.
Pharmacoepidemiol Drug Saf. 2024 Aug;33(8):e5882. doi: 10.1002/pds.5882.
The purpose of this study is to evaluate the pattern, appropriateness, and cost of antidiabetic drugs prescribed for patients with Type 2 diabetes at primary healthcare facilities (PHFs) in China.
We collected outpatient-visit prescriptions from 363 PHFs in 31 cities covering eastern, central, and western regions of China. The visits of adult patients with Type 2 diabetes diagnosis were collected and classified the antidiabetic medication pattern of each patient use as recommended or non-recommended according to Chinese guidelines. We then calculated the proportion of guideline-recommended patterns and the average monthly cost for each pattern, overall and by region.
Of 33 519 prescriptions for Type 2 diabetes, most (73.9%) were for guideline-recommended antidiabetic treatments. The proportion of guideline-recommended prescriptions varied by region (eastern [75.9%], central [87.5%], and western [59.7%]). Metformin monotherapy was the most common guideline-recommended treatment in all three regions (eastern [20.1%], central [28.0%], and western [24.6%]). The most common non-guideline-recommended treatments were monotherapy of insulin (eastern [16.5%], central [5.1%], and western [25.7%]) and traditional Chinese antidiabetic medicines (eastern [5.6%], central [5.7%], and western [11.1%]). The average monthly costs were lower for guideline-recommended treatments compared to non-recommended treatments in all regions (eastern [13.6 ± 15.4 USD vs. 28.1 ± 22.0 USD], central [9.8 ± 10.9 USD vs. 28.7 ± 19.4 USD], and western [17.9 ± 21.4 USD vs. 30.3 ± 23.6 USD]).
The majority of patients with Type 2 diabetes received guideline-recommended antidiabetic medications at PHFs in China, with only half of the prescriptions containing guideline-recommended metformin. Utilization of guideline-recommended therapies differed across regions. Tailored interventions to promote evidence-based antidiabetic prescribing are urgently needed, especially in the undeveloped western region.
本研究旨在评估中国基层医疗机构（PHF）治疗 2 型糖尿病患者的降糖药物模式、适宜性和费用。
我们从中国东部、中部和西部地区的 31 个城市的 363 家 PHF 收集了门诊处方。收集了成年 2 型糖尿病患者的就诊信息，并根据中国指南将每位患者的降糖药物模式分为推荐和非推荐。然后，我们计算了每个模式的推荐模式比例和平均每月费用，包括总体和按地区。
在 33519 例 2 型糖尿病处方中，大多数（73.9%）为指南推荐的降糖治疗。处方推荐率因地区而异（东部[75.9%]、中部[87.5%]和西部[59.7%]）。二甲双胍单药治疗是所有三个地区最常见的指南推荐治疗方法（东部[20.1%]、中部[28.0%]和西部[24.6%]）。最常见的非指南推荐治疗方法是胰岛素单药治疗（东部[16.5%]、中部[5.1%]和西部[25.7%]）和传统中药降糖药（东部[5.6%]、中部[5.7%]和西部[11.1%]）。所有地区的推荐治疗方案的平均每月费用均低于非推荐治疗方案（东部[13.6±15.4 美元比 28.1±22.0 美元]、中部[9.8±10.9 美元比 28.7±19.4 美元]和西部[17.9±21.4 美元比 30.3±23.6 美元]）。
中国大多数 2 型糖尿病患者在 PHF 接受了指南推荐的降糖药物治疗，只有一半的处方含有指南推荐的二甲双胍。不同地区的指南推荐治疗方案的使用情况存在差异。迫切需要采取有针对性的干预措施，促进基于证据的降糖药物处方，特别是在欠发达的西部地区。
