Treatment of type 2 diabetes in primary health care: a drug utilization study.
BACKGROUND
Metabolic control in type 2 diabetes depends on patient adherence to therapy. Quantitative consumption data do not supply information regarding the appropriate use of medicine. Drug utilization studies are useful to identify treatment adherence problems and, thus, design interventions to improve drug use.


OBJECTIVE
To describe the treatment and outcome in terms of degree of metabolic control in these patients, assess the agreement between the doses of antidiabetic drugs reported by the patient and those written in the medical record, and describe the drug utilization characteristics in relation to the standards of care.


METHODS
This drug utilization study was conducted in primary care centers in Barcelona, Spain. Consecutive patients with type 2 diabetes attending a follow-up visit were interviewed regarding lifestyle, diet, glycosylated hemoglobin level, and treatment. Concordance between the information obtained through medical records and patient interviews was analyzed.


RESULTS
Metabolic control was deficient in 73 (40%), acceptable in 50 (28%), and good in 58 (32%) of the 181 patients with available information. For 38 (19%) patients, there was disagreement between the dose of the antidiabetic drug reported by the patient and that written in the medical record. For 83 (41%) patients, the treatment in the medical history was in agreement with published standards.


CONCLUSIONS
Identification of disagreement between standards of care and clinical practice in type 2 diabetes management is the basis to improve drug utilization and achieve better metabolic control in these patients.
Mino-León
Dolores
D
Medical Research Coordination, Social Security Mexican Institute, National Medical Center, Siglo XXI, Mexico City, Mexico.
Figueras
Albert
A
Amato
Dante
D
Laporte
Joan-Ramon
JR
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010349:Patient Compliance; D011320:Primary Health Care
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin