[Antidiabetic drugs prescription patterns among a group of patients in Colombia]. / Patrones de prescripción de antidiabéticos en un grupo de pacientes colombianos.

OBJECTIVES: To identify prescription patterns for diabetes treatment among a group of individuals covered by Colombia's universal health care, the General System for Social Security in Health (SGSSS). METHODS: The study included 7 308 patients covered by SGSSS who had diabetes mellitus type 1 or 2, were of either sex, any age, and had been undergoing treatment for at least three months (May-July 2005) in 19 cities in Colombia. A database was compiled from the medication usage records maintained by the dispensing pharmacy. Data were analyzed using SPSS 13.0 (SPSS Inc., Chicago, Illinois, United States of America). Student's t-test and analysis of variance (ANOVA) were employed to compare quantitative variables, and the chi-square test was applied to compare categorical variables. RESULTS: The patients' mean age was 60.7 +/- 12.7 years. Women made up 56.6% of the group and had a mean age significantly higher than that of the men (P < 0.05). Forty-eight percent of the group had been prescribed one diabetes medication, while 52% had been prescribed from two to four. The medications prescribed were: biguanides (67.5%), sulphonylureas (64.9%), insulin (23.5%), and thiazolidinediones (0.1%). The most common oral combination-therapies were: glibenclamide and metformin (n = 2 847), metformin and insulin (n = 510), glibenclamide and insulin (n = 148), and metformin, insulin, and glibenclamide (n = 288). Of the total, 94.3% had comorbid conditions for which they had been prescribed medication: antihypertensive drugs (in 74.4% of the cases), anti-inflammatories (61.5%), hypolipemiants (45.5%), antiulcer medications (21.0%), psychoactive drugs (16.8%), antimicrobials (14.4%), asthma medication (5.3%), and salicylic acid (2.8%). Prescriptions for comorbid conditions were more common among women than men (95.6% vs. 92.7%, P < 0.001). Undertreatment with certain medications (metformin, thiazolidinediones, alpha-glucosidase inhibitors, and salicylic acid), and overtreatment with others (antiulcer drugs), probably exist. CONCLUSIONS: There are significant differences in oral therapies prescribed for diabetes across the 19 cities studied, but overall, prescription patterns are appropriate. Educational strategies should be developed to address those prescribing practices that are not appropriate, and the clinical results of the medications studied should be explored.

Patrones de prescripción de antidiabéticos en un grupo de pacientes colombianos / Antidiabetic drugs prescription patterns among a group of patients in Colombia

OBJETIVOS: Determinar los patrones de prescripción de medicamentos antidiabéticos en un grupo de personas afiliadas al Sistema General de Seguridad Social en Salud (SGSSS) de Colombia. MÉTODOS: Se incluyeron en el estudio 7 308 afiliados al SGSSS con diabetes de tipo 1 ó 2, de ambos sexos y de todas las edades, tratados durante por lo menos tres meses (de mayo a julio de 2005) en 19 ciudades colombianas. Se diseñó una base de datos de los registros de consumo de medicamentos de la empresa dispensadora de fármacos. Los datos se analizaron con el paquete estadístico SPSS 13 para Windows, empleando la prueba de la t de Student y el análisis de la varianza (ANOVA) para comparar variables cuantitativas y la prueba de la x² para comparar variables categóricas. RESULTADOS: La edad media de los pacientes era de 60,7 ± 12,7 años; el 56,6 por ciento eran mujeres, de edad media significativamente mayor que la de los hombres (P < 0,05). El 48 por ciento de las personas recibía monoterapia y el 52 por ciento, politerapia con entre dos y cuatro antidiabéticos. Los antidiabéticos prescritos fueron: biguanidas (67,5 por ciento de los casos), sulfonilureas (64,9 por ciento), insulinas (23,5 por ciento) y tiazolidindionas (0,1 por ciento). Las asociaciones más empleadas fueron: glibenclamida + metformina (n = 2 847), metformina + insulina (n = 510), glibenclamida + insulina (n = 148) y metformina + insulina + glibenclamida (n = 288). El 94,3 por ciento de los pacientes recibían un tratamiento concomitante: antihipertensivos (74,4 por ciento), antiinflamatorios (61,5 por ciento), hipolipemiantes (45,5 por ciento), antiulcerosos (21 por ciento), psicofármacos (16,8 por ciento), antiinfecciosos (14,4 por ciento), antiasmáticos (5,3 por ciento) y ácido acetilsalicílico (2,8 por ciento). La comedicación era más frecuente en las mujeres que en los hombres (95,6 por ciento frente a 92,7 por ciento, P < 0,001). Probablemente haya subempleo de algunos fármacos...

OBJECTIVES: To identify prescription patterns for diabetes treatment among a group of individuals covered by Colombia's universal health care, the General System for Social Security in Health (SGSSS). METHODS: The study included 7 308 patients covered by SGSSS who had diabetes mellitus type 1 or 2, were of either sex, any age, and had been undergoing treatment for at least three months (May-July 2005) in 19 cities in Colombia. A database was compiled from the medication usage records maintained by the dispensing pharmacy. Data were analyzed using SPSS 13.0 (SPSS Inc., Chicago, Illinois, United States of America). Student's t-test and analysis of variance (ANOVA) were employed to compare quantitative variables, and the chi-square test was applied to compare categorical variables. RESULTS: The patients' mean age was 60.7 ± 12.7 years. Women made up 56.6 percent of the group and had a mean age significantly higher than that of the men (P < 0.05). Forty-eight percent of the group had been prescribed one diabetes medication, while 52 percent had been prescribed from two to four. The medications prescribed were: biguanides (67.5 percent), sulphonylureas (64.9 percent), insulin (23.5 percent), and thiazolidinediones (0.1 percent). The most common oral combination-therapies were: glibenclamide and metformin (n = 2 847), metformin and insulin (n = 510), glibenclamide and insulin (n = 148), and metformin, insulin, and glibenclamide (n = 288). Of the total, 94.3 percent had comorbid conditions for which they had been prescribed medication: antihypertensive drugs (in 74.4 percent of the cases), anti-inflammatories (61.5 percent), hypolipemiants (45.5 percent), antiulcer medications (21.0 percent), psychoactive drugs (16.8 percent), antimicrobials (14.4 percent), asthma medication (5.3 percent), and salicylic acid (2.8 percent). Prescriptions for comorbid conditions were more common among women than men (95.6 percent vs. 92.7 percent, P < 0.001). Undertreatment...