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Bächle, C.* ; Claessen, H.* ; Maier, W. ; Tamayo, T.* ; Schunk, M. ; Rückert-Eheberg, I.-M. ; Holle, R. ; Meisinger, C. ; Moebus, S.* ; Jöckel, K.H.* ; Schipf, S.* ; Völzke, H.* ; Hartwig, S.* ; Kluttig, A.* ; Kroll, L.E.* ; Linnenkamp, U.* ; Icks, A.*

Regional differences in antihyperglycemic medication are not explained by individual socioeconomic status, regional deprivation, and regional health care services. Observational results from the German DIAB-CORE consortium.

PLoS ONE 13:e0191559 (2018)
Verlagsversion DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
Aims This population-based study sought to extend knowledge on factors explaining regional differences in type 2 diabetes mellitus medication patterns in Germany. Methods Individual baseline and follow-up data from four regional population-based German cohort studies (SHIP [northeast], CARLA [east], HNR [west], KORA [south]) conducted between 1997 and 2010 were pooled and merged with both data on regional deprivation and regional health care services. To analyze regional differences in any or newer anti-hyperglycemic medication, medication prevalence ratios (PRs) were estimated using multivariable Poisson regression models with a robust error variance adjusted gradually for individual and regional variables. Results The study population consisted of 1,437 people aged 45 to 74 years at baseline, (corresponding to 49 to 83 years at follow-up) with self-reported type 2 diabetes. The prevalence of receiving any anti-hyperglycemic medication was 16% higher in KORA (PR 1.16 [1.08 +/- 1.25]), 10% higher in CARLA (1.10 [1.01 +/- 1.18]), and 7% higher in SHIP (PR 1.07 [1.00 +/- 1.15]) than in HNR. The prevalence of receiving newer anti-hyperglycemic medication was 49% higher in KORA (1.49 [1.09 +/- 2.05]), 41% higher in CARLA (1.41 [1.02 +/- 1.96]) and 1% higher in SHIP (1.01 [0.72 +/- 1.41]) than in HNR, respectively. After gradual adjustment for individual variables, regional deprivation and health care services, the effects only changed slightly. Conclusions Neither comprehensive individual factors including socioeconomic status nor regional deprivation or indicators of regional health care services were able to sufficiently explain regional differences in anti-hyperglycemic treatment in Germany. To understand the underlying causes, further research is needed.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Population; Prevalence; Cohort; Odds
Sprache
Veröffentlichungsjahr 2018
HGF-Berichtsjahr 2018
ISSN (print) / ISBN 1932-6203
Zeitschrift PLoS ONE
Quellenangaben Band: 13, Heft: 1, Seiten: , Artikelnummer: e0191559 Supplement: ,
Verlag Public Library of Science (PLoS)
Verlagsort Lawrence, Kan.
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Health Economics and Health Care Management (IGM)
Institute of Epidemiology (EPI)
POF Topic(s) 30202 - Environmental Health
90000 - German Center for Diabetes Research
Forschungsfeld(er) Genetics and Epidemiology
PSP-Element(e) G-505300-001
G-505300-002
G-504000-006
G-501900-401
G-504090-001
DOI 10.1371/journal.pone.0191559
WOS ID WOS:000423416600062
Scopus ID 85041111960
PubMed ID 29370228
Erfassungsdatum 2018-03-01
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