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Transitions of Care for People with Type 2 Diabetes: Utilization of Antihyperglycemic Agents Pre- and Post-Hospitalization
INTRODUCTION: Little research to date has examined antihyperglycemic agent (AHA) utilization among patients with type 2 diabetes mellitus (T2DM) around transitions of care from inpatient to outpatient settings. Discontinuity of care between inpatient and outpatient settings has been associated with...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Healthcare
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801813/ https://www.ncbi.nlm.nih.gov/pubmed/26659004 http://dx.doi.org/10.1007/s13300-015-0148-5 |
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author | Montejano, Leslie Vo, Lien McMorrow, Donna |
author_facet | Montejano, Leslie Vo, Lien McMorrow, Donna |
author_sort | Montejano, Leslie |
collection | PubMed |
description | INTRODUCTION: Little research to date has examined antihyperglycemic agent (AHA) utilization among patients with type 2 diabetes mellitus (T2DM) around transitions of care from inpatient to outpatient settings. Discontinuity of care between inpatient and outpatient settings has been associated with adverse clinical outcomes, so a better understanding of AHA treatment patterns is important. METHODS: This retrospective study assessed AHA utilization among a sample of United States adults with a T2DM diagnosis listed on an inpatient admission during 2010–2012 in the MarketScan(®) Hospital Drug database (Truven Health Analytics). AHA use while hospitalized was measured from inpatient medication administration records in that database. AHA use pre- and post-hospitalization was assessed from outpatient retail and mail order pharmacy claims in the MarketScan Commercial and Medicare Supplemental databases, which contain de-identified insurance claims from large employers and health plans. The hospital and claims databases are linked, allowing patients to be followed across transitions of care. RESULTS: The study sample (N = 8144) was 53% male, with a mean age of 66 years. Twenty-one percent had no T2DM diagnosis or claims for AHAs in the 90-day pre-hospitalization period suggesting they may have been newly diagnosed at the time of admission. Most (83%) patients used AHAs while hospitalized, but the proportions with AHA claims 30 days pre- and post-hospitalization were only 53% and 40%, respectively. Biguanides and sulfonylureas were the most common outpatient agents. Most (70%) patients who had no AHA utilization pre-hospitalization continued to have no AHA utilization post-hospitalization. About half the patients with AHA claims pre-hospitalization did not have any AHA claims post-discharge. CONCLUSION: Further research is warranted to explore the reasons why AHAs are not continued following hospital discharge. Inadequate treatment of T2DM remains an issue before and after hospitalization; inpatient stays represent an important and frequently missed opportunity to assess and optimize care for these patients. FUNDING: Janssen Scientific Affairs, LLC. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13300-015-0148-5) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4801813 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-48018132016-04-06 Transitions of Care for People with Type 2 Diabetes: Utilization of Antihyperglycemic Agents Pre- and Post-Hospitalization Montejano, Leslie Vo, Lien McMorrow, Donna Diabetes Ther Original Research INTRODUCTION: Little research to date has examined antihyperglycemic agent (AHA) utilization among patients with type 2 diabetes mellitus (T2DM) around transitions of care from inpatient to outpatient settings. Discontinuity of care between inpatient and outpatient settings has been associated with adverse clinical outcomes, so a better understanding of AHA treatment patterns is important. METHODS: This retrospective study assessed AHA utilization among a sample of United States adults with a T2DM diagnosis listed on an inpatient admission during 2010–2012 in the MarketScan(®) Hospital Drug database (Truven Health Analytics). AHA use while hospitalized was measured from inpatient medication administration records in that database. AHA use pre- and post-hospitalization was assessed from outpatient retail and mail order pharmacy claims in the MarketScan Commercial and Medicare Supplemental databases, which contain de-identified insurance claims from large employers and health plans. The hospital and claims databases are linked, allowing patients to be followed across transitions of care. RESULTS: The study sample (N = 8144) was 53% male, with a mean age of 66 years. Twenty-one percent had no T2DM diagnosis or claims for AHAs in the 90-day pre-hospitalization period suggesting they may have been newly diagnosed at the time of admission. Most (83%) patients used AHAs while hospitalized, but the proportions with AHA claims 30 days pre- and post-hospitalization were only 53% and 40%, respectively. Biguanides and sulfonylureas were the most common outpatient agents. Most (70%) patients who had no AHA utilization pre-hospitalization continued to have no AHA utilization post-hospitalization. About half the patients with AHA claims pre-hospitalization did not have any AHA claims post-discharge. CONCLUSION: Further research is warranted to explore the reasons why AHAs are not continued following hospital discharge. Inadequate treatment of T2DM remains an issue before and after hospitalization; inpatient stays represent an important and frequently missed opportunity to assess and optimize care for these patients. FUNDING: Janssen Scientific Affairs, LLC. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13300-015-0148-5) contains supplementary material, which is available to authorized users. Springer Healthcare 2015-12-11 2016-03 /pmc/articles/PMC4801813/ /pubmed/26659004 http://dx.doi.org/10.1007/s13300-015-0148-5 Text en © The Author(s) 2015 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Research Montejano, Leslie Vo, Lien McMorrow, Donna Transitions of Care for People with Type 2 Diabetes: Utilization of Antihyperglycemic Agents Pre- and Post-Hospitalization |
title | Transitions of Care for People with Type 2 Diabetes: Utilization of Antihyperglycemic Agents Pre- and Post-Hospitalization |
title_full | Transitions of Care for People with Type 2 Diabetes: Utilization of Antihyperglycemic Agents Pre- and Post-Hospitalization |
title_fullStr | Transitions of Care for People with Type 2 Diabetes: Utilization of Antihyperglycemic Agents Pre- and Post-Hospitalization |
title_full_unstemmed | Transitions of Care for People with Type 2 Diabetes: Utilization of Antihyperglycemic Agents Pre- and Post-Hospitalization |
title_short | Transitions of Care for People with Type 2 Diabetes: Utilization of Antihyperglycemic Agents Pre- and Post-Hospitalization |
title_sort | transitions of care for people with type 2 diabetes: utilization of antihyperglycemic agents pre- and post-hospitalization |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801813/ https://www.ncbi.nlm.nih.gov/pubmed/26659004 http://dx.doi.org/10.1007/s13300-015-0148-5 |
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