Pharmacoepidemiological profiles of oral hypoglycemic agents among 28,773 Chinese patients with diabetes.
OBJECTIVE
This study examined the rates of discontinuation of Oral Hypoglycemic Agents (OHAs) in diabetes patients, and to evaluate the associations between discontinuation of OHAs, socioeconomic status and the number of comorbidities.


METHODS
A cohort study from January 2004 to June 2007 was conducted and followed up through December 2007. We included all primary care clinics in one large territories of Hong Kong involving 28,773 Chinese diabetes patients. Multivariate regression analyses controlled for age, gender, payment status (fee-payers vs. fee waivers; fee-waivers represented those less able to pay for consultation fees and were regarded as having lower socioeconomic status), service type delivered by the clinics, district of residence, visit type (new vs. follow-up), the number of comorbidities and the drug class (sulphonylureas vs. biguanide vs. combination therapy).


RESULTS
9.9% discontinued their medications within 180 days of their prescriptions. Fee waivers (adjusted odds ratio [AOR] for fee payers=0.81, 95% C.I. 0.73-0.89, p<0.001) and the absence of comorbidities (AOR for ≥one morbidity=0.59-0.62, p<0.001) were associated with medication discontinuation.


CONCLUSIONS
Diabetes patients with lower ability to pay and without comorbidities were significantly associated with OHAs discontinuation. They should be the target groups for medication counseling programmes.
Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. wong_martin@cuhk.edu.hk
Martin C S
MC
Wong
Alice P S
AP
Kong
W Y
WY
So
Shelly L A
SL
Tse
Harry H X
HH
Wang
Johnny Y
JY
Jiang
Juliana C N
JC
Chan
Sian M
SM
Griffiths
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D015331:Cohort Studies; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000187:drug effects / Q000378:metabolism*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000191:economics; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D017891:Pharmacoepidemiology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D028761:Withholding Treatment / Q000191:economics / Q000706:statistics & numerical data*; D016903:Drug Monitoring
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human