Antidiabetic and Cardiovascular Drugs in T2DM Patients > 80
A population-based cohort study was conducted using the UK Clinical Practice Research Datalink (CPRD). The CPRD is a database containing anonymised longitudinal electronic health records collected from primary care across the UK. The database currently collects data from 680 general practices and includes 13.2 million patients, of which 5.7 million individuals are active. CPRD data for prescriptions and diagnoses have been shown to be valid. This study was approved by the CPRD Independent Scientific Advisory Committee (ISAC Protocol 14_053).
A population-based cohort of patients aged 80 years or older with diabetes diagnosed between January 1990 and December 2013 was identified from the CPRD. The diagnosis date of diabetes was defined as earlier of the first diagnosis of diabetes or the first prescription for antidiabetic drugs. Patients with potential type 1 diabetes mellitus were excluded. Patients first diagnosed over the age of 80 years, with at least 12-month record before the diagnosis date, were identified as incident cases. An incident cohort was selected, and only patients with T2DM who were ever prescribed antidiabetic drugs were selected. All patients were followed up until the earliest of death, transferred out from the database or last data collection for the practice.
We evaluated the utilisation of antidiabetic drugs (British National Formulary sections 6.1.1 and 6.1.2), antihypertensive drugs (2.2.1, 2.4, 2.5.5 and 2.6.2), lipid-lowering drugs (2.12), antiplatelets (2.9, oral drugs only) and oral anticoagulants (2.8.2). All prescriptions after the diagnosis date of T2DM were counted by drug class.
Baseline characteristics of the study cohort were described. Logistic regression was used to evaluate the trend of drug utilisation. Effects of gender and age group on prescriptions of drugs were assessed by estimating odds ratio (OR) and 95% confidence interval (95% CI). Analyses were adjusted for gender, age group, diagnosis year (3-year interval) and clustering by general practice. All analyses were performed with STATA version 13 (StataCorp., TX, USA).
Methods
Data Source
A population-based cohort study was conducted using the UK Clinical Practice Research Datalink (CPRD). The CPRD is a database containing anonymised longitudinal electronic health records collected from primary care across the UK. The database currently collects data from 680 general practices and includes 13.2 million patients, of which 5.7 million individuals are active. CPRD data for prescriptions and diagnoses have been shown to be valid. This study was approved by the CPRD Independent Scientific Advisory Committee (ISAC Protocol 14_053).
Study Population
A population-based cohort of patients aged 80 years or older with diabetes diagnosed between January 1990 and December 2013 was identified from the CPRD. The diagnosis date of diabetes was defined as earlier of the first diagnosis of diabetes or the first prescription for antidiabetic drugs. Patients with potential type 1 diabetes mellitus were excluded. Patients first diagnosed over the age of 80 years, with at least 12-month record before the diagnosis date, were identified as incident cases. An incident cohort was selected, and only patients with T2DM who were ever prescribed antidiabetic drugs were selected. All patients were followed up until the earliest of death, transferred out from the database or last data collection for the practice.
Analysis
We evaluated the utilisation of antidiabetic drugs (British National Formulary sections 6.1.1 and 6.1.2), antihypertensive drugs (2.2.1, 2.4, 2.5.5 and 2.6.2), lipid-lowering drugs (2.12), antiplatelets (2.9, oral drugs only) and oral anticoagulants (2.8.2). All prescriptions after the diagnosis date of T2DM were counted by drug class.
Baseline characteristics of the study cohort were described. Logistic regression was used to evaluate the trend of drug utilisation. Effects of gender and age group on prescriptions of drugs were assessed by estimating odds ratio (OR) and 95% confidence interval (95% CI). Analyses were adjusted for gender, age group, diagnosis year (3-year interval) and clustering by general practice. All analyses were performed with STATA version 13 (StataCorp., TX, USA).