Summary
This article reviews the data from drug utilisation research on antidiabetic agents, oral hypoglycaemics and insulin. Study methods specific to this type of pharmacoepidemiological research are discussed and critiqued. A brief overview of the sources of drug utilisation data is presented, followed by a review of specific pharmacoepidemiological investigations. We evaluate the usefulness of these studies in assessing true drug consumption, in evaluating comorbidity in diabetic patients and in measuring the prevalence of diabetes. International comparisons of antidiabetic drug utilisation, also reviewed and analysed, demonstrate wide variations in the use of hypoglycaemic agents, which have arisen for reasons which are unclear. Drug utilisation research thus far has been limited by the paucity of studies relating these variations in antidiabetic drug use to specific clinical outcomes. There is a need to expand the applications of research on the use of antidiabetic agents, including assessment of patterns of morbidity across geographic boundaries and over time.
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References
Baum C, Kennedy DL, Knapp DE, Juergens JP, Faith GA. Prescription drug use in 1984 and changes over time. Medical Care 26: 105–114, 1988
Bergman U. Utilization of antidiabetic drugs in the island of Götland, Sweden: agreement between wholesale figures and prescription data. European Journal of Clinical Pharmacology 14: 213–220, 1978
Bergman U: International comparisons of drug utilization: use of antidiabetic drugs in seven European countries. In Bergman et al. (Eds). Studies in drug utilization: methods and applications, p. 147, WHO, Copenhagen, 1979
Bergman U, Elmes P, Halse M, Halvorsen T, Hood M, et al. The measurement of drug consumption: drugs for diabetes in Northern Ireland, Norway and Sweden. European Journal of Clinical Pharmacology 8: 83–89, 1975
Bergman U, Grimsson A, Wahba AHW, et al. (Eds). Studies in drug utilization: European Series No. 8, WHO Regional Office for Europe, Copenhagen, 1979
Bergstrom I, Boethius G, Wiman F. Sjukdomspanorama utlast ur en lakemedelsregistrering. Lakartidningen 69: Suppl. IV 34–37, 1972
Carson JL, Strom BL, Morse ML. Medicaid data bases. In Strom (Ed.) Pharmacoepidemiology — the science of post-marketing drug surveillance, Vol. 14, pp. 173–188, Churchill Livingstone, New York, 1989
Damsgaard EM. Prevalence and incidence of Type II diabetes in Denmark compared with other countries. Acta Endocrinologica 262 (Suppl.): 21–26, 1984
Drury TF, Powell AL. Prevalence of known diabetes among Black Americans. National Center for Health Statistics, Advance Data No. 130, 1987 European Marketing Data and Statistics. Euromonitor Publications Ltd, London, 1973
FDA Drug utilization in the US 1987. Ninth Annual Review, Food and Drug Administration, Rockville, 1988
Fontbonne A, Papoz L, Eschwege E. Drug sales data and prevalence of diabetes in France. Revue d’Epidémiologie et de Santé Publique 34: 100–105, 1986
Friedman GD. Kaiser Permanente Medical Care Program: Northern California and other regions. In Strom (Ed.) Pharmacoepidemiology — the science of post-marketing drug surveillance, Vol. 13, pp. 161–172, Churchill Livingstone, New York, 1989
Griffiths K, McDevitt DG, Andrew M, Baksaas I, Helgeland A, et al. Therapeutic traditions in Northern Ireland, Norway and Sweden: I. diabetes. European Journal of Clinical Pharmacology 30: 513–519, 1986
Griffiths K, McDevitt DG, Andrew M, Baksaas I, Lunde PKM, et al. Validation of observed differences in the utilization of antihypertensive and antidiabetic drugs in Northern Ireland, Norway and Sweden. European Journal of Clinical Pharmacology 29: 1–8, 1985
Harlow SC, Linett MS. Agreement between questionnaire data and medical records: the evidence for accuracy of recall. American Journal of Epidemiology 129: 233–248, 1989
IMS Research Group. A special analysis of the National Disease and Therapeutics Index Service for the Pharmaceutical Industry, IMS America, Ambler, 1979
Isacson D, Stålhammar J. Prescription drug use among diabetics: a population study. Journal of Chronic Diseases 40: 651–660, 1987
Jervell J. Antidiabetic drug. In Sakshaug et al. (Eds) Drug utilization in Norway during the 1970s: increases, inequalities, and innovations, Norwegian Medicinal Depot, Oslo, 1983
Joner G, Søvik O. Incidence, age at onset, and seasonal variation of diabetes mellitus in Norwegian children, 1973–1977. Acta Paediatrica Scandinavica 70: 329–355, 1981
Jones JK, Kennedy DL. Data sources and methods for ascertaining human exposure to drugs. Journal of Toxicology — Clinical Toxicology 21: 237–251, 1983
Kennedy DL, Piper JM, Baum C. Trends in use of oral hypoglycemic agents 1964-1986. Diabetes Care 11: 558–562, 1988
Knowler WC, Bennett PH, Hamman RF, Miller M. Diabetes incidence and prevalence in Pima Indians: a 19-fold greater incidence than in Rochester, Minnesota. American Journal of Epidemiology 108: 497–505, 1978
Lee D, Bergman U. Studies of drug utilization. In Strom (Ed.) Pharmacoepidemiology, p. 259, Churchill Livingstone, New York, 1989
Lilja J. The nationalization of the Swedish pharmacies. Social Science and Medicine 24: 423–429, 1987
Lunde PKM, Andrew M. Baksaas I. Drug utilization — an instrument in drug research. In Kewitz et al. (Eds). Epidemio-logical concepts in clinical pharmacology, p.57, Springer-Verlag, Berlin, 1987
Melton LJ, Palumbo J, Chu CP. Incidence of diabetes mellitus by clinical type. Diabetes Care 6: 75–86, 1983
NCHS. Vital and health statistics of the National Center for Health Statistics, No. 134, 1987a
NCHS. Highlights of drug utilization in office practice: National Ambulatory Medical Care Survey, 1985. National Center for Health Statistics, Advance Data No. 137, 1987b
Rendell M. Lassek WD, Ross DA, Smith C, Kernek S, et al. A pharmaceutical profile of diabetic patients. Journal of Chronic Diseases 36: 193–202, 1983
Sagild U, Littauer J, Jespersen CS, Andersen S. Epidemiological studies in Greenland 1962–1964: I. diabetes mellitus in Eskimos. Acta Medica Scandinavica 179: 29–39, 1966
Serradell J, Bjornson DC, Hartzema AG. Drugs utilization study methodologies: national and international perspectives. Drug Intelligence and Clinical Pharmacy 21: 994–1001, 1987
Sjöqvist F, Agenäs I (Eds). Drug utilization studies: implications for medical care. Acta Medica Scandinavica 683: 1, 1984
Staff AC, Baksaas I. An estimation of the prevalence of diabetes mellitus in Norway: a prescription registration study. Scandinavian Journal of Primary Health Care 6: 233–237, 1988
Stanulović M, Jakovljević V, Kovač T, Lepšanović L, Dučić M. Regional and international comparison in utilization of anti-diabetic drugs. International Journal of Clinical Pharmacology Therapy and Toxicology 24: 254–256, 1986
Štika L. Patterns in drug utilization — national and international aspects: antidiabetic drugs. Acta Medica Scandinavica 683 Suppl: 53–57, 1984
Stergachis A. Group Health Cooperative of Puget Sound, Medicaid data bases. In Strom (Ed.) Pharmacoepidemiology — the science of post-marketing drug surveillance, Vol. 12, pp. 149–160, Churchill Livingstone, New York, 1989
Stolley PD. The problem of drug utilization and the role of the WHO, DEM/75.5, World Health Organization, Geneva, 1975
Strand LM, West R. Health data bases in Saskatchewan. In Strom (Ed.) Pharmacoepidemiology — the science of post-marketing drug surveillance, Vol. 15, pp. 189–200, Churchill Livingstone, New York, 1989
University Group Diabetes Program. A study of the effect of hypoglycemic agents on vascular complications in patients with adult-onset diabetes: I. Design, methods and baseline results. Diabetes, 19 (Suppl. 2): 747–783, 1970
USDC. Pharmaceutical preparations, except biologicals. Current Industrial Reports: US Department of Commerce, Bureau of the Census, 1986
Zimmet P, Seluka A, Collins J, Currie P, Wiching J, et al. Diabetes mellitus in an urbanized, isolated Polynesian population: the Funafuti survey. Diabetes 26: 1101–1108, 1977
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Feldman, H.I., Strom, B.L. Utilisation of Drugs for Diabetes Mellitus. Drug-Safety 6, 220–229 (1991). https://doi.org/10.2165/00002018-199106030-00006
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DOI: https://doi.org/10.2165/00002018-199106030-00006