title: Trends in drug prescriptions to diabetic patients from 2000 to 2008 in Italy's Lombardy Region: a large population-based study.
abstract: OBJECTIVE
  To analyze the prescribing patterns of antidiabetic and cardiovascular medications among diabetics in the most highly populated Italian Region, from 2000 to 2008.
  
  
  METHODS
  Data were obtained from the Lombardy Region administrative health databases. The standardized prevalence of antidiabetic and cardiovascular drugs use was calculated within each study year. The prescription trends of initial treatment with antidiabetic drugs were also analyzed.
  
  
  RESULTS
  From 2000 to 2008 there was an increase in the proportion of patients treated with biguanides (from 53.4% to 66.5%; p<0.0001) while those receiving sulfonylurea decreased (from 78.6% to 56.4%; p<0.0001). A sharp increase of metformin (as monotherapy) as initial treatment was also observed (from 15.2% to 48.8%; p<0.0001). The percentage of patients receiving renin-angiotensin system inhibitors, lipid-lowering drugs and antiplatelets increased between 2000 and 2008, from respectively 45.1% to 63.3%, 13.6% to 43.2% and 21.6% to 40.9 (p<0.0001). Multivariate analyses indicated that changes in prescriptions were statistically significant for both antidiabetic and cardiovascular drugs.
  
  
  CONCLUSIONS
  This study documents progressive changes in the prescription of antidiabetic and cardiovascular drugs in accordance with guidelines. However, the use of metformin as first line therapy was still suboptimal and cardiovascular preventive strategies were only partially implemented in community practice.
authors.affiliation: Laboratory of General Practice Research, Mario Negri Institute for Pharmacological Research, Via Giuseppe La Masa 19, 20156 Milan, Italy. mbaviera@marionegri.it
authors.forename: Marta
authors.initials: M
authors.lastname: Baviera
authors.forename: Lara
authors.initials: L
authors.lastname: Monesi
authors.forename: Irene
authors.initials: I
authors.lastname: Marzona
authors.forename: Fausto
authors.initials: F
authors.lastname: Avanzini
authors.forename: Gabriella
authors.initials: G
authors.lastname: Monesi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nobili
authors.forename: Mauro
authors.initials: M
authors.lastname: Tettamanti
authors.forename: Emma
authors.initials: E
authors.lastname: Riva
authors.forename: Laura
authors.initials: L
authors.lastname: Cortesi
authors.forename: Angela
authors.initials: A
authors.lastname: Bortolotti
authors.forename: Ida
authors.initials: I
authors.lastname: Fortino
authors.forename: Luca
authors.initials: L
authors.lastname: Merlino
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Fontana
authors.forename: Maria Carla
authors.initials: MC
authors.lastname: Roncaglioni
mesh_terms: D003920:Diabetes Mellitus / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007558:Italy; D008687:Metformin / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D013453:Sulfonylurea Compounds / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors; D013453:Sulfonylurea Compounds; D008687:Metformin