Real World Use of Antidiabetic Drugs in the Years 2011–2017: A Population-Based Study from Southern Italy

Ylenia Ingrasciotta, Maria Paola Bertuccio, Salvatore Crisafulli, Valentina Ientile, Marco Muscianisi, Luca L’Abbate, Maurizio Pastorello, Vincenzo Provenzano, Alessandro Scorsone, Salvatore Scondotto and Gianluca Trifirò
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Ylenia Ingrasciotta: Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
Maria Paola Bertuccio: Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
Salvatore Crisafulli: Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
Valentina Ientile: Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
Marco Muscianisi: Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
Luca L’Abbate: Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
Maurizio Pastorello: Palermo Local Health Unit, Department of Pharmacy, 90127 Palermo, Italy
Vincenzo Provenzano: Regional Referral Centre for Insulin Pump Implantation and Diabetes, Civic Hospital, Partinico, 90047 Palermo, Italy
Alessandro Scorsone: Regional Referral Centre for Insulin Pump Implantation and Diabetes, Civic Hospital, Partinico, 90047 Palermo, Italy
Salvatore Scondotto: Department of Epidemiologic Observatory, Health Department of Sicily, 90127 Palermo, Italy
Gianluca Trifirò: Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Italy

IJERPH, 2020, vol. 17, issue 24, 1-21

Abstract: Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia. The availability of new antidiabetic drugs (ADs) has led to complex treatment patterns and to changes in the patterns of specific drug utilization. The aim of this population-based study was to describe the pattern of antidiabetic drugs (ADs) use in Southern Italy in the years 2011–2017, in relation to the updated type 2 diabetes mellitus (T2DM) therapy guidelines. A retrospective cohort study was conducted on T2DM patients using data from the Palermo Local Health Unit (LHU) claims database and diabetologist registry. The first-line treatment was investigated and incident treatments were identified and characterized at baseline in terms of demographics, complications, comorbidities, concomitant drugs and clinical parameters. Persistence to AD treatment was also evaluated. During the study period, one-third of first ever ADs users started the treatment with ADs other than metformin, in contrast to guideline recommendations. Among 151,711 incident AD treatments, the male to female ratio was 1.0 and the median age was 66 (57–75) years. More than half (55.0%) of incident treatments discontinued the therapy during the first year of treatment. In Italy, general practitioners (GPs) can only prescribe first-generation ADs, while the prescription of more recently marketed ADs, such as GLP-1RA, DPP4i and SGLT2i, is restricted to diabetologists only, based on a therapeutic plan. The role of GPs in the management of T2DM in Italy should be re-evaluated.

Keywords: antidiabetic drugs; real world data; type 2 diabetes mellitus; therapy guidelines; Southern Italy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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