In the UK, drug therapy of T2DM shifted from sulphonylureas to metformin (Hamada and Gulliford, 2015). In this case, metformin prescription has largely increased from 55.4% in 2000 to 83.6% in 2013 and sulfonylureas decreased from 64.8% to 41.4% in 2000 and 2013 respectively. In relation to insulin, prescription remained stable with 20-24% of treated patients (Sharma, Nazareth and Petersen, 2016). In other countries, metformin is reported to be the most commonly prescribed drug for patients with drug monotherapy (Mor et al., 2015; Higgins et al., 2016).
In relation to newly diagnosed patients, from 2003 to 2005 a retrospective study in the UK reported that 36%, 42% and 51% of patients with T2DM initiated with antihyperglycemic therapy within …show more content…
In this instance, the use of Metformin decrease with age and sulphonylureas increase with patient age (Sinclair et al., 2012). Similarly, in the US Zhang et al. reported to be metformin the most frequent initial prescription, but was less likely to be prescribed to older patients. For older patients, the initial prescription was more often sulphonylureas (Zhang et al., 2012). Likewise, in a study among patients with T2DM over 80 years, sulphonylureas were more likely to be prescribed to older patients (90 years and over) (Hamada and Gulliford, 2015).
Albeit drug choice seems to have a closer relation to patients’ age, Grant et al. reported that the major consideration when choosing which drug to prescribe first was the assessment of the patients’ health status and co-morbid conditions, in second place was the extent of HbA1c elevation (Grant et al., …show more content…
However, it can influence the prescription patterns, for instance, Gelhorn et al. reports that patients at advances stages of the disease tend to consider potentially beneficial aspects of the medication as well as efficacy and hypoglycemic risk (Gelhorn et al., 2013). Similarly, Mullan et al. found that a decision aid was effective in promoting patients involvement in drug choice, and that patients were more often interested in some particular side effects such as weight change (Mullan et al., 2009).
3.0 Conclusion
Drug treatment initiation encompasses a complex net of factors related to healthcare system patients and physicians. As most of the studies focused on barriers to insulin initiation or oral medication, the underlying reasons or factors influencing time to treatment and treatment choice need further exploration. Moreover, barriers to initiating drug treatment in older patients older require additional research for understanding difference between younger and older patients.
In order to understand how and when GPs decide to start drug treatment for their patients with T2DM and what other factors influence treatment decisions, a quantitative and qualitative approach are
In relation to newly diagnosed patients, from 2003 to 2005 a retrospective study in the UK reported that 36%, 42% and 51% of patients with T2DM initiated with antihyperglycemic therapy within …show more content…
In this instance, the use of Metformin decrease with age and sulphonylureas increase with patient age (Sinclair et al., 2012). Similarly, in the US Zhang et al. reported to be metformin the most frequent initial prescription, but was less likely to be prescribed to older patients. For older patients, the initial prescription was more often sulphonylureas (Zhang et al., 2012). Likewise, in a study among patients with T2DM over 80 years, sulphonylureas were more likely to be prescribed to older patients (90 years and over) (Hamada and Gulliford, 2015).
Albeit drug choice seems to have a closer relation to patients’ age, Grant et al. reported that the major consideration when choosing which drug to prescribe first was the assessment of the patients’ health status and co-morbid conditions, in second place was the extent of HbA1c elevation (Grant et al., …show more content…
However, it can influence the prescription patterns, for instance, Gelhorn et al. reports that patients at advances stages of the disease tend to consider potentially beneficial aspects of the medication as well as efficacy and hypoglycemic risk (Gelhorn et al., 2013). Similarly, Mullan et al. found that a decision aid was effective in promoting patients involvement in drug choice, and that patients were more often interested in some particular side effects such as weight change (Mullan et al., 2009).
3.0 Conclusion
Drug treatment initiation encompasses a complex net of factors related to healthcare system patients and physicians. As most of the studies focused on barriers to insulin initiation or oral medication, the underlying reasons or factors influencing time to treatment and treatment choice need further exploration. Moreover, barriers to initiating drug treatment in older patients older require additional research for understanding difference between younger and older patients.
In order to understand how and when GPs decide to start drug treatment for their patients with T2DM and what other factors influence treatment decisions, a quantitative and qualitative approach are