Use of drugs related to the treatment of diabetes mellitus and other cardiovascular risk factors in the Spanish population. The Di@bet.es study.

INTRODUCTION AND OBJECTIVES To assess the patterns of use of 8 therapeutic drug groups for the treatment of diabetes mellitus and other cardiovascular risk factors, and to identify sociodemographic and health determinants of their use in the overall Spanish population. METHODS A representative sample of the Spanish population within the Di@bet.es study, a cross-sectional population-based survey, was included. STUDY VARIABLES sociodemographic, clinical, and lifestyle data; physical examination, and an oral glucose tolerance test in patients without known diabetes mellitus. Furthermore, patients were systematically queried about current medication use, and 8 pharmacotherapeutic groups were evaluated: lipid-lowering therapy, antihypertensives, oral hypoglycemic agents, insulin, thyroid hormone, uricosurics, psychoactive drugs, and nonsteroidal anti-inflammatory drugs. RESULTS Sixty-six percent of the Spanish population was taking at least one medication. Therapeutic drug use was associated with age, independently of the higher prevalence of diabetes mellitus, hypertension, or hyperlipidemia in older patients. Sex disparities were found in the use of lipid-lowering agents, allopurinol, levothyroxine, nonsteroidal anti-inflammatory drugs, and psychoactive drugs. Use of psychoactive drugs was related to education level, work status, physical activity, smoking, and alcohol consumption. Almost 30% of patients with diabetes mellitus were taking 6 or more medications daily. Diabetes mellitus was associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs. CONCLUSIONS Age and sex are the most important factors determining therapeutic drug use. Lifestyle patterns and sociocultural factors have an impact only on psychoactive drug use. Diabetes mellitus is associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs.

[1]  Plamen Nikolov,et al.  Economic Costs of Diabetes in the U.S. in 2002 , 2003, Diabetes care.

[2]  M. S. Kirkman,et al.  Comment on: American Diabetes Association. Standards of Medical Care in Diabetes—2011. Diabetes Care 2011;34(Suppl. 1):S11–S61 , 2011 .

[3]  T. Pigott,et al.  Gender differences in the epidemiology and treatment of anxiety disorders. , 1999, The Journal of clinical psychiatry.

[4]  J. Bottomley,et al.  Economic costs of diabetes in the US in 2007 — Implications for Europe , 2008 .

[5]  Y. Gustafson,et al.  Gender Disparities in the Pharmacological Treatment of Cardiovascular Disease and Diabetes Mellitus in the Very Old , 2011, Drugs & aging.

[6]  M. Ganguli,et al.  Use of Prescription Medications in an Elderly Rural Population: The Movies Project , 1996, The Annals of pharmacotherapy.

[7]  Y. Jang,et al.  Standards of Medical Care in Diabetes-2010 by the American Diabetes Association: Prevention and Management of Cardiovascular Disease , 2010 .

[8]  E. Hummers-Pradier,et al.  Prevalence and predictors of polypharmacy among older primary care patients in Germany. , 2006, Family practice.

[9]  B. Modan,et al.  Patterns of drug use among the community-dwelling old-old population in Israel. , 2003, The Israel Medical Association journal : IMAJ.

[10]  C. Roe,et al.  Gender- and Age-Related Prescription Drug Use Patterns , 2002, The Annals of pharmacotherapy.

[11]  A. León,et al.  Cardiovascular Risk Factors in Spain in the First Decade of the 21st Century, a Pooled Analysis With Individual Data From 11 Population-Based Studies: the DARIOS Study , 2011 .

[12]  E. López-de-Sá,et al.  Carga económica y social de la enfermedad coronaria , 2013 .

[13]  P. Zimmet,et al.  Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation , 1998, Diabetic medicine : a journal of the British Diabetic Association.

[14]  Jing Jin,et al.  Factors affecting therapeutic compliance: A review from the patient’s perspective , 2008, Therapeutics and clinical risk management.

[15]  H. Britt,et al.  Sex differences in prescribed medications: another case of discrimination in general practice. , 1997, Social science & medicine.

[16]  Donald R. Miller,et al.  Gender disparities in lipid-lowering therapy among veterans with diabetes. , 2011, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[17]  C. Bartlett,et al.  Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs , 2012, Diabetic medicine : a journal of the British Diabetic Association.

[18]  I. E. D. Antonio,et al.  Depresion en la diabetes mellitus tipo 1 y factores asociados , 2010 .

[19]  C. Metge,et al.  The population's use of pharmaceuticals. , 1999, Medical care.

[20]  Tim Nolan,et al.  International Diabetes Federation. , 2013, Diabetes research and clinical practice.

[21]  V. Basevi,et al.  Standards of Medical Care in Diabetes—2012 , 2011, Diabetes Care.

[22]  J. L. Merino,et al.  Resultados e implicaciones del estudio ROCKET , 2013 .

[23]  Dong Jun Kim Summary of the American Diabetes Association Standards of Medical Care in Diabetes 2012 , 2012 .

[24]  J. Hibbard,et al.  Another look at sex differences in the use of medical care: illness orientation and the types of morbidities for which services are used. , 1986, Women & health.

[25]  R. Gomis,et al.  Prevalence of diabetes mellitus and impaired glucose regulation in Spain: the Di@bet.es Study , 2011, Diabetologia.

[26]  F. McAlister,et al.  Antihypertensive medication prescribing in 27,822 elderly Canadians with diabetes over the past decade. , 2006, Diabetes care.

[27]  M. Lapeyre-Mestre,et al.  Evolution of drug consumption in a sample of French workers since 1986: the ‘Drugs and Work’ study , 2009, Pharmacoepidemiology and drug safety.

[28]  D. Fernández-Bergés,et al.  [Cardiovascular risk factors in Spain in the first decade of the 21st Century, a pooled analysis with individual data from 11 population-based studies: the DARIOS study]. , 2011, Revista espanola de cardiologia.