アブストラクト | OBJECTIVE: To evaluate oral anticoagulant (OAC) prescribing trends in type 2 diabetes mellitus (T2DM) in the UK from 2001 to 2015. DESIGN: A cross-sectional drug utilisation study. SETTING: Electronic health records from The Health Improvement Network primary care database in the UK. PARTICIPANTS: Individuals with T2DM who received a record of OAC prescription. OUTCOME MEASURES: The prescribing trends of OAC medications in individuals with T2DM were examined from 2001 to 2015, stratified by age, gender and therapeutic classifications. RESULTS: A total of 361 635 individuals with T2DM were identified, of whom 36 570 were prescribed OAC from 2001 to 2015. The prevalence of OAC prescribing increased by 50.0%, from 1781 individuals receiving OAC prescriptions (IROACP) (4.4 (95% CI 4.2 to 4.6) per 100 persons) in 2001, to 17 070 IROACP (6.6 (95% CI 6.5 to 6.7) per 100 persons) in 2015. The prevalence of warfarin prescribing decreased by 14.0%, from 1761 individuals receiving warfarin prescriptions (IRWP) (98.9 (95% CI 98.4 to 99.4) per 100 persons) in 2001, to 14 533 IRWP (85.1 (95% CI 84.6 to 85.7) per 100 persons) in 2015. This corresponded with increased prescribing of direct oral anticoagulants (DOACs), from 18 individuals receiving DOAC prescriptions (IRDOACP) (0.1 (95% CI 0.08 to 0.23) per 100 persons) in 2010, to 3016 IRDOACP (17.6 (95% CI 17.1 to 18.2) per 100 persons) in 2015, during the same period. CONCLUSIONS: Prescribing of OACs in individuals with T2DM increased from 2001 to 2015. Since the introduction of DOACs, there has been a clear shift in prescribing towards these agents. Future studies are needed to assess the safety of coadministration of OAC medications and antidiabetic therapy with T2DM. |
投稿者 | Alwafi, Hassan; Wei, Li; Naser, Abdallah Y; Mongkhon, Pajaree; Tse, Gary; Man, Kenneth K C; Bell, J Simon; Ilomaki, Jenni; Fang, Gang; Wong, Ian C K |
組織名 | Research Department of Practice and Policy, School of Pharmacy, University;College London, London, London, UK.;Faculty of Pharmacy, Isra University, Amman, Jordan.;Division of Pharmacy Practice, Department of Pharmaceutical Care, School of;Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.;Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy,;Chiang Mai University, Chiang Mai, Thailand.;Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University;of Hong Kong, New Territories, Hong Kong.;Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University;Centre for Safe Medication Practice and Research, Department of Pharmacology and;Pharmacy, The University of Hong Kong, Hong Kong, Hong Kong.;Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria,;Australia.;Division of Pharmaceutical Outcomes and Policy, University of North Carolina at;Chapel Hill, Chapel Hill, North Carolina, USA.;College London, London, London, UK wongick@hku.hk.;Pharmacology and Pharmacy, University of Hong Kong, Hong Kong, Hong Kong. |