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Initial Therapeutic Choices for Type 2 Diabetes in the Portuguese Sentinel Practice Network

2019-05-31Artigo científico Acesso aberto
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dc.contributor.authorPinto, Daniel
dc.contributor.authorRodrigues, Ana Paula
dc.contributor.authorNunes, Baltazar
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblBiblioteca Nacional de Portugal, Centro de Estudos Históricos, CELOM
dc.date.accessioned2019-07-29T22:40:36Z
dc.date.available2019-07-29T22:40:36Z
dc.date.issued2019-05-31
dc.description.abstractINTRODUCTION: Type 2 diabetes is a major driver of pharmaceutical spending. We aimed to determine the proportion of new patients who begin treatment with each antidiabetic medicine class, if therapy was initiated by their family physician, if family physicians alter prescriptions initiated by other physicians, and to compare prescribing patterns of family physicians and other specialists. MATERIAL AND METHODS: Cohort-nested cross-sectional study within the Portuguese Sentinel Practice Network. Between 2014 and 2015, incident cases of type 2 diabetes were notified, thus reporting treatment, who made the initial prescription and if treatments initiated by other physicians were changed. RESULTS: A total of 415 incident cases were notified. The initial prescription was made by Sentinel Practice Network physicians in 89.4% of cases (95% CI 86.0% - 92.0%). Metformin was most often chosen as the first treatment, prescribed to 85.5% of patients (95% CI 81.8% - 88.6%). Family physicians used less dipeptidyl peptidase-4 inhibitors (4.2% vs 30.3%, p < 0.001) and insulin (0.3% vs 12.1%, p < 0.001) compared to other specialists. Prescriptions initiated by others were changed in 4.5% of cases (95% CI 0.4% - 16.0%). DISCUSSION: Prospective data collection is a major study strength, but few cases of treatment initiated by non-family physicians were notified. Data for disease severity was unavailable and could partly explain differences between family physicians and other specialists. CONCLUSION: Metformin was most often chosen as initial therapy, in line with Portuguese guideline recommendations. Sentinel Practice Network physicians diagnosed most cases, seldom changed prescriptions initiated by others, and had a different pattern of antidiabetic medicines use compared to other specialists.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent6
dc.format.extent280661
dc.identifier.doi10.20344/amp.10414
dc.identifier.issn1646-0758
dc.identifier.otherPURE: 14019296
dc.identifier.otherPURE UUID: 674e6e8f-7f97-445e-b0f7-c325f9846079
dc.identifier.otherScopus: 85067433805
dc.identifier.otherPubMed: 31166898
dc.identifier.otherWOS: 000469935100009
dc.identifier.urihttp://www.scopus.com/inward/record.url?scp=85067433805&partnerID=8YFLogxK
dc.identifier.urlhttps://www.scopus.com/pages/publications/85067433805
dc.language.isoeng
dc.peerreviewedyes
dc.subjectDiabetes Mellitus, Type 2/drug therapy
dc.subjectHypoglycemic Agents
dc.subjectPortugal
dc.subjectPrimary Health Care
dc.subjectSentinel Surveillance
dc.subjectGeneral Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleInitial Therapeutic Choices for Type 2 Diabetes in the Portuguese Sentinel Practice Networken
dc.typejournal article
degois.publication.firstPage375
degois.publication.issue5
degois.publication.lastPage380
degois.publication.titleActa Médica Portuguesa
degois.publication.volume32
dspace.entity.typePublication
rcaap.rightsopenAccess

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