TY - JOUR
T1 - Change of initial oral antidiabetic therapy in type 2 diabetic patients
AU - Plat, Arian
AU - Penning-Van Beest, Fernie
AU - Kessabi, Sophia
AU - Groot, Martijn
AU - Herings, Ron
N1 - Funding Information: Funding This study was financially supported by an unrestricted grant from Novartis Pharma AG, Basel, Switzerland.
PY - 2009/12
Y1 - 2009/12
N2 - Objective To explore the 'real-life' therapy of type 2 diabetes mellitus with oral antidiabetic drugs (OADs). Methods From the PHARMO Record Linkage System comprising linked drug dispensing and clinical laboratory data from approximately 2.5 million individuals in the Netherlands, among others, new users of OADs were identified in the period 1999-2004. New users, aged 30 years and older, without insulin use before cohort entry date and with at least one year follow-up were included. We determined per initial therapy patient characteristics and first therapy change. Results Overall 35,514 patients were included. Metformin and sulfonylureas (SU) were the most frequent initial therapy. Patients on thiazolidinedione (TZD) monotherapy had lower percentages baseline HbA1c ≥ 7% compared to patients on metformin and SU. The proportion of patients still on initial therapy after one year ranged from 46% (TZDs) to around 60% (SU). Among patients starting on monotherapy, add-on (15-20%) and discontinuation (16-25%) of therapy occurred most frequently. In patients starting on combination therapy, a switch occurred in 30% of the patients. Conclusion In more than 40% of the patients a change in initial OAD-therapy is already observed in the first year of therapy. Maintaining patients on initial therapy remains a challenge.
AB - Objective To explore the 'real-life' therapy of type 2 diabetes mellitus with oral antidiabetic drugs (OADs). Methods From the PHARMO Record Linkage System comprising linked drug dispensing and clinical laboratory data from approximately 2.5 million individuals in the Netherlands, among others, new users of OADs were identified in the period 1999-2004. New users, aged 30 years and older, without insulin use before cohort entry date and with at least one year follow-up were included. We determined per initial therapy patient characteristics and first therapy change. Results Overall 35,514 patients were included. Metformin and sulfonylureas (SU) were the most frequent initial therapy. Patients on thiazolidinedione (TZD) monotherapy had lower percentages baseline HbA1c ≥ 7% compared to patients on metformin and SU. The proportion of patients still on initial therapy after one year ranged from 46% (TZDs) to around 60% (SU). Among patients starting on monotherapy, add-on (15-20%) and discontinuation (16-25%) of therapy occurred most frequently. In patients starting on combination therapy, a switch occurred in 30% of the patients. Conclusion In more than 40% of the patients a change in initial OAD-therapy is already observed in the first year of therapy. Maintaining patients on initial therapy remains a challenge.
KW - Diabetes
KW - Netherlands
KW - Oral antidiabetic agents
KW - Pharmacoepidemiology
KW - Treatment pattern
UR - http://www.scopus.com/inward/record.url?scp=76749137099&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s11096-009-9321-0
DO - https://doi.org/10.1007/s11096-009-9321-0
M3 - Article
C2 - 19690978
SN - 0928-1231
VL - 31
SP - 622
EP - 626
JO - Pharmacy World and Science
JF - Pharmacy World and Science
IS - 6
ER -