TREATMENT PATTERNS AND ACHIEVEMENT OF THERAPEUTIC GOALS IN A COHORT OF TYPE 2 DIABETES MELLITUS PATIENTS TREATED IN THE BRAZILIAN PRIVATE HEALTH CARE SYSTEM (PHCS)- INITIAL REPORTS OF DIAPS 79 STUDY
Author(s)
DIAPS79 study grou P1, Eliaschewitz FG2, Bahia L3, Cintra M4, Franco L5, Nita ME6, Rached R61Diabetes Mellitus Type 2 in the Brazilian Private Health Care System DIAPS79, São Paulo, SP, Brazil, 2CPCLIN – Centro de Pesquisas Clínicas, São Paulo, SP, Brazil, 3MedInsight, Rio de Janeiro, RJ, Brazil, 4MedInsight, Rio de Janeiro, Rio de Janeiro, Brazil, 5FMUSP/Ribeirão Preto, São Paulo, SP, Brazil, 6Bristol-Myers Squibb S/A, São Paulo, SP, Brazil
OBJECTIVES: Investigate the type 2 diabetes mellitus (T2DM) treatment practice and achievement of therapeutic goals in a cohort of T2DM patients treated in the Brazilian PHCS. METHODS: This is a cross-sectional analysis of 383 T2DM outpatients treated in 5 cities covered by the PHCS. Data was collected using information from the previous year by interviewing patients using a validated questionnaire complemented by medical chart review. Therapeutic goals suggested by the Brazilian Diabetes Society were used as standard treatment. RESULTS: Mean age was 60.5±9.6 years, mean BMI 29.1±5.3 Kg/m2 and mean duration of diabetes of 12.2±8.75 years. The frequency of associated arterial hypertension was 66.8% (n=256); obesity 39% n=144); dyslipidemia 69.6% (n=267) and heart failure 5.5% (n=21). Microvascular complications were present in 32.4% (n=124); 8.1% (n=31) had macrovascular complications; 18% (n=69) had at least one micro and one macrovascular complication and 41.5% (n=159) had no complications. Current treatment practice was: 3.6% (n=14) diet only; 30% (n=115) monotherapy with oral anti-diabetic (OAD); 37.8% (n=145) combined therapy with more than one OAD agents; 23.2% (n=89) combined therapy with insulin and 5.2% (n=20) just insulin. The most prescribed drug was metformin (41.4%), followed by insulin (19.1%), sulphonylureas (18.6%), DPP4 inhibitors (8.7%), TZDs (5.5%), and others (6.7%). Medications for dyslipidemia was used by 47.5% (n= 178); cardiovascular drugs in 77.4% (n=287) and anti-obesity drugs in 4% (n=15). Treatment targets were achieved in: 76.8% for systolic and diastolic blood pressure (<130x85 mmHg), 19.5% for BMI < 25kg/m2, 28% for HDL cholesterol >55 women, 37.3% for HDL cholesterol >45 men and 28.2% reached the goal for HbA1c (within normal range). Only 6.8% of the group (n=26) reached all the treatment targets. CONCLUSIONS: The national goals for glycemic control, blood pressure and lipid levels are rarely achieved in real-world clinical practice, even with the high use of medications.
Conference/Value in Health Info
2010-11, ISPOR Europe 2010, Prague, Czech Republic
Value in Health, Vol. 13, No. 7 (November 2010)
Code
PDB91
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Treatment Patterns and Guidelines
Disease
Diabetes/Endocrine/Metabolic Disorders