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Published Online, 8 February 2005, www.theannals.com, DOI 10.1345/aph.1E273.
 The Annals of Pharmacotherapy: Vol. 39, No. 3, pp. 441-445. DOI 10.1345/aph.1E273
© 2005 Harvey Whitney Books Company.
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DIABETES

Treatment of Type 2 Diabetes in Primary Health Care: A Drug Utilization Study

Dolores Mino-León, MD

Researcher, Medical Research Coordination, Social Security Mexican Institute, National Medical Center, Siglo XXI, Mexico City, Mexico

Albert Figueras, MD

Associate Professor, Catalan Institute of Pharmacology, Pharmacology, Therapeutics and Toxicology Department, Autonomous University of Barcelona, Vall d'Hebron Hospital, Barcelona, Spain

Dante Amato, MD

Researcher, Medical Research Coordination, Social Security Mexican Institute, National Medical Center, Siglo XXI

Joan-Ramon Laporte, MD

Professor, Catalan Institute of Pharmacology, Pharmacology, Therapeutics and Toxicology Department, Autonomous University of Barcelona, Vall d'Hebron Hospital

Reprints: Dr. Laporte, Fundació Institut Català de Farmacologia, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, E-08035, Barcelona, Spain, fax 34-93-489-41-09, jrl{at}icf.uab.es

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.

Key Words: adherence, metabolic control, oral hypoglycemic drugs, type 2 diabetes

Published Online, February 8, 2005. www.theannals.com, DOI 10.1345/aph.1E273




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