Limits...
Trends and Determinants of Oral Anti-Diabetic Initiation in Youth with Suspected Type 2 Diabetes.

Cai M, Kappelman MD, Girman CJ, Jain N, Stürmer T, Brookhart MA - PLoS ONE (2015)

Bottom Line: Time trends demonstrate a 43% increase in initiation from 2002-2012, with a gradual decrease starting from early 2008.Incidence of filled OAD medications in youth increased over time, especially for patients treated by family practitioners.Additional research is needed into factors influencing prescribing by family practitioners and pediatricians.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, United States of America.

ABSTRACT

Objective: To evaluate trends and identify predictors of treatment initiation of oral anti-diabetic drugs (OAD) in youth.

Patients and methods: We identified a select population of children, ages 8-18 years, with at least 13 months of continuous health plan coverage within the years 2001-2012 in a large US commercial insurance claims database. New use of an OAD was defined as the first claim for an outpatient dispensing following a 12-month wash out period. Treatment incidence was estimated monthly over the study period, and stratified by age, gender, geographic region, and provider specialty.

Results: The median size of the source population during the study period was 2.2 million children. A total of 13,824 initiators (mean monthly incidence of 4.6 (95% CI = 3.6, 5.5) per 100,000 youths) were identified. Initiators were more likely to be females, age 15-18, from the southern region, and have visited a family practitioner (versus a general pediatrician) prior to initiation. Time trends demonstrate a 43% increase in initiation from 2002-2012, with a gradual decrease starting from early 2008.

Conclusion: Incidence of filled OAD medications in youth increased over time, especially for patients treated by family practitioners. Additional research is needed into factors influencing prescribing by family practitioners and pediatricians.

No MeSH data available.


Overall Population Trends: Incidence Trends per 100 000 Youth.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4624874&req=5

pone.0140611.g001: Overall Population Trends: Incidence Trends per 100 000 Youth.

Mentions: The temporal trends in overall and subgroup specific monthly incidence rates are presented in Table 3 and visually depicted in Figs 1–4. Fig 1 illustrates an increase in overall incidence between years 2002 (3.0 per 100,000 youth) to early 2008 (5.3 per 100,000), before gradually declining during the remainder of the study period (4.3 per 100,000 in 2012), suggesting a corresponding 43% increase in new users over the course of 11 years. This pattern was also reflected consistently in all age group specific trends (Fig 2) and to a lesser extent, the regional trends. Gender-specific initiation rates over time illustrated differences in temporal trends between male and female patients (Fig 3). Female incidence increased by 45% between 2002 to early 2008 before experiencing a 12% decrease for the remainder of the study period. Overall, the female population underwent a 62% increase in usage over 11-years. The male population experienced their peak in incidence 2-years earlier than females in 2006 where rates increased by 67% from 2002. Their overall increase during the study period was 28%, demonstrating a lesser increase compared to their female counterparts. At all time points, individuals with visits to a FP physician were approximately twice as likely to initiate OAD as compared to individuals with visits to a general pediatrician (Fig 4). Individual trends show an 89% increase in FP prescriptions from 2002 to mid-2009 and then dropping by 11% during the remainder of the study. Pediatrician trends suggest a 95% increase in prescriptions from 2002 to early 2007, before experiencing a 14% drop over the course of the remaining 5-years of the study period. Overall, FPs and pediatricians experienced similar percent increases in prescriptions over the duration of the study, 67% and 68%, respectively.


Trends and Determinants of Oral Anti-Diabetic Initiation in Youth with Suspected Type 2 Diabetes.

Cai M, Kappelman MD, Girman CJ, Jain N, Stürmer T, Brookhart MA - PLoS ONE (2015)

Overall Population Trends: Incidence Trends per 100 000 Youth.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4624874&req=5

pone.0140611.g001: Overall Population Trends: Incidence Trends per 100 000 Youth.
Mentions: The temporal trends in overall and subgroup specific monthly incidence rates are presented in Table 3 and visually depicted in Figs 1–4. Fig 1 illustrates an increase in overall incidence between years 2002 (3.0 per 100,000 youth) to early 2008 (5.3 per 100,000), before gradually declining during the remainder of the study period (4.3 per 100,000 in 2012), suggesting a corresponding 43% increase in new users over the course of 11 years. This pattern was also reflected consistently in all age group specific trends (Fig 2) and to a lesser extent, the regional trends. Gender-specific initiation rates over time illustrated differences in temporal trends between male and female patients (Fig 3). Female incidence increased by 45% between 2002 to early 2008 before experiencing a 12% decrease for the remainder of the study period. Overall, the female population underwent a 62% increase in usage over 11-years. The male population experienced their peak in incidence 2-years earlier than females in 2006 where rates increased by 67% from 2002. Their overall increase during the study period was 28%, demonstrating a lesser increase compared to their female counterparts. At all time points, individuals with visits to a FP physician were approximately twice as likely to initiate OAD as compared to individuals with visits to a general pediatrician (Fig 4). Individual trends show an 89% increase in FP prescriptions from 2002 to mid-2009 and then dropping by 11% during the remainder of the study. Pediatrician trends suggest a 95% increase in prescriptions from 2002 to early 2007, before experiencing a 14% drop over the course of the remaining 5-years of the study period. Overall, FPs and pediatricians experienced similar percent increases in prescriptions over the duration of the study, 67% and 68%, respectively.

Bottom Line: Time trends demonstrate a 43% increase in initiation from 2002-2012, with a gradual decrease starting from early 2008.Incidence of filled OAD medications in youth increased over time, especially for patients treated by family practitioners.Additional research is needed into factors influencing prescribing by family practitioners and pediatricians.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, United States of America.

ABSTRACT

Objective: To evaluate trends and identify predictors of treatment initiation of oral anti-diabetic drugs (OAD) in youth.

Patients and methods: We identified a select population of children, ages 8-18 years, with at least 13 months of continuous health plan coverage within the years 2001-2012 in a large US commercial insurance claims database. New use of an OAD was defined as the first claim for an outpatient dispensing following a 12-month wash out period. Treatment incidence was estimated monthly over the study period, and stratified by age, gender, geographic region, and provider specialty.

Results: The median size of the source population during the study period was 2.2 million children. A total of 13,824 initiators (mean monthly incidence of 4.6 (95% CI = 3.6, 5.5) per 100,000 youths) were identified. Initiators were more likely to be females, age 15-18, from the southern region, and have visited a family practitioner (versus a general pediatrician) prior to initiation. Time trends demonstrate a 43% increase in initiation from 2002-2012, with a gradual decrease starting from early 2008.

Conclusion: Incidence of filled OAD medications in youth increased over time, especially for patients treated by family practitioners. Additional research is needed into factors influencing prescribing by family practitioners and pediatricians.

No MeSH data available.