Temporal trends in, and associations of, early-career general practitioner prescriptions of second-line Type 2 Diabetes medications, 2010–2018

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Patsan, Irena
Tapley, Amanda
Davoren, Peter
Fielding, Alison
Holliday, Elizabeth
Ball, Jean
Davey, Andrew
van Driel, Mieke
Turner, Rachel
Mulquiney, Katie
Spike, Neil
FitzGerald, Kristen
Magin, Parker
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2023
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Abstract

Introduction: Second-line pharmacotherapy for Type 2 Diabetes Mellitus (‘diabetes’) is necessary for optimal glycaemic control and preventing longer-term complications. We aimed to describe temporal trends in, and associations of, Australian general practitioner (GP) registrars’ prescription, and initiation, of ‘new’ second-line oral agents (dipeptidyl peptidase 4 inhibitors, sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 agonists) compared to sulphonylureas. Materials and methods: A longitudinal analysis (2010–2018) of data from the Registrar Clinical Encounters in Training project. Analysis included any diabetes problem/diagnosis that involved prescription of sulphonylureas or ‘new’ oral agents. Simple and multiple logistic regression models were fitted within the generalised estimating equations framework. Results: 2333 registrars recorded 6064 diabetes problems/diagnoses (1.4%). 835 problems/diagnoses involved sulphonylurea or ‘new’ medication prescription. Of these, 61.0% [95% CI:57.4–64.4] involved ‘new’ medication prescription. 230 problems/diagnoses involved sulphonylurea or ‘new’ medication initiation, with 77% [95%CI:70.8–82.1] involving a ‘new’ medication. There was a significant 52% per year increase in prescribing (OR = 1.52[95% CI:1.38–1.68],p<0.001), and a 77% per (two-to-three-year) time-interval increase in initiation (OR = 1.77,[95% CI:1.30–2.43],p = <0.001) of ‘new’ medications compared to sulphonylureas. ‘New’ medications were prescribed less for non-English-speaking patients. There was some regional variation in prescribing. Conclusion; Registrar uptake of ‘new’ oral agents compared to sulphonylureas has increased rapidly.

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PLoS ONE

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18

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1

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© 2023 Patsan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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General practice

Endocrinology

Epidemiology

Science & Technology

Multidisciplinary Sciences

Science & Technology - Other Topics

HEART-FAILURE

MELLITUS

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Patsan, I; Tapley, A; Davoren, P; Fielding, A; Holliday, E; Ball, J; Davey, A; van Driel, M; Turner, R; Mulquiney, K; Spike, N; FitzGerald, K; Magin, P, Temporal trends in, and associations of, early-career general practitioner prescriptions of second-line Type 2 Diabetes medications, 2010–2018, PLoS ONE, 2023, 18 (1), pp. e0280668

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