Prevalence and epidemiology of diabetes in Canadian primary care practices: a report from the Canadian Primary Care Sentinel Surveillance Network.
OBJECTIVE
The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) is a large, validated national primary care Electronic Medical Records (EMR)-based database. Our objective was to describe the epidemiology of diabetes in this Canadian sample.


METHODS
We analyzed the records of 272 469 patients10 years of age and older, with at least 1 primary care clinical encounter between January 1, 2011, and December 31, 2012. We calculated the age-gender standardized prevalence of diabetes. We compared health care utilization and comorbidities for 7 selected chronic conditions in patients with and without diabetes. We also examined patterns of medication usage.


RESULTS
The estimated population prevalence of diabetes was 7.6%. Specifically, we studied 25 425 people with diabetes who had at least 1 primary care encounter in 2 years. On average, patients with diabetes had 1.42 times as many practice encounters as patients without diabetes (95% CI 1.42 to 1.43, p<0.0001). Patients with diabetes had 1.29 times as many other comorbid conditions as those without diabetes (95% CI 1.27 to 1.31, p<0.0001). We found that 85.2% of patients taking hypoglycemic medications were taking metformin, and 51.8% were taking 2 or more classes of medications.


CONCLUSIONS
This study is the first national Canadian report describing the epidemiology of diabetes using primary care EMR-based data. We found significantly higher rates of primary care use, and greater numbers of comorbidities in patients with diabetes. Most patients were on first-line hypoglycemic medications. Data routinely recorded in EMRs can be used for surveillance of chronic diseases such as diabetes in Canada. These results can enable comparisons with other national EMR-based datasets.
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; North York General Hospital, Toronto, Ontario, Canada. Electronic address: mgreiver@rogers.com.
Michelle
M
Greiver
Department of Family Medicine, Queen's University, Kingston, Ontario, Canada; Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
Tyler
T
Williamson
Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.
David
D
Barber
Department of Family Medicine, Queen's University, Kingston, Ontario, Canada; Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
Richard
R
Birtwhistle
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; North York General Hospital, Toronto, Ontario, Canada.
Babak
B
Aliarzadeh
Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.
Shahriar
S
Khan
Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.
Rachael
R
Morkem
Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Gayle
G
Halas
Department of Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
Stewart
S
Harris
Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Alan
A
Katz
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002170:Canada / Q000453:epidemiology; D002648:Child; D002908:Chronic Disease; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data; D018571:Sentinel Surveillance
D007004:Hypoglycemic Agents
computerized; diabetes mellitus; diabète sucré; drug therapy; epidemiology; informatisé; medical record systems; pharmacothérapie; systèmes de dossiers médicaux; épidémiologie