Identification of Patients with Type 2 Diabetes Mellitus Requiring Concentrated Pharmaceutical Management in Health Insurance Pharmacies:

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  • Iketani Ryo
    National Institute of Public Health, Center for Outcomes Research and Economic Evaluation for Health
  • Konomura Keiko
    National Institute of Public Health, Center for Outcomes Research and Economic Evaluation for Health

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Other Title
  • 保険薬局において重点的薬学管理を必要とする2型糖尿病患者の特定：
  • Quantitative Evaluation Using Administrative Claims Data
  • レセプトデータを用いた定量的評価

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<p>The present nested case-control study aimed to clarify the type of patients with type 2 diabetes mellitus that required concentrated pharmaceutical management in health insurance pharmacies by detecting factors associated with the calculation of chouhukutouyaku-sougosayoutou-boushi-kasan. We detected the factors of patients on the JMDC claims database who met the eligibility criteria between April 1, 2018, and August 31, 2019, by using the multiple logistic regression model. For the analyses detecting the factors, 63,642 patients (case, 4,987; control, 58,655) were included. Regarding the calculation other than the adjustment of leftover drugs, 12 factors were statistically detected. Polypharmacy was most related to the calculation (odds ratio, 1.50; 95％ confidence interval, 1.35 - 1.66). The drugs concerned were mainly for lifestyle diseases (biguanides, dipeptidyl peptidase-4 inhibitors, glinides, glucagon-like peptide-1 agonists, alpha-glucosidase inhibitors, and hypolipidemic drugs). Regarding the calculation related to the adjustment of leftover drugs, 15 factors were statistically detected. Polypharmacy was most related to the calculation (odds ratio, 2.36; 95％ confidence interval, 2.02 - 2.76). The drugs concerned were mainly for non-lifestyle diseases (proton-pump inhibitors, H2 blockers, H1 blockers, antipsychotics, antidepressants, non-steroidal anti-inflammatory drugs, antimicrobial drugs, steroids, probiotics, and vitamins). Moreover, the increases in the detected factors positively possessed by the subject correlated with the calculations. The present study suggests, for patients with type 2 diabetes mellitus, that more attention should be paid to the interactions and duplicated prescriptions when increasing drugs for chronic diseases, and that more attention should be paid to leftover drugs when increasing drugs for temporary symptoms.</p>

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