PDF(Pubmed)
Abstract：
OBJECTIVE: Diabetes is a major public health problem in Canada and requires multifactorial, consistent clinical management. The COVID-19 pandemic has increased challenges in the management of many chronic ailments, including diabetes. Diabetes was associated with a higher risk of severe illness in the context of COVID-19. Pandemic restrictions also impacted diabetes care continuity, which may have contributed to an increased risk of diabetes-related complications and mortality.
METHODS: This was a retrospective cross-sectional study of prescription patterns of antihyperglycemic medications claimed by individuals with type 2 diabetes (T2D) before and during the COVID-19 pandemic using the IQVIA Canada Longitudinal Prescription Claims database. The study period was from March 1, 2018, to February 28, 2021. The study outcomes are described on a monthly, quarterly, and yearly basis and overall, and by medication, medication class, and insurance coverage type. \"New-to-molecule\" patients were defined as those claiming a medication during the analysis period that they had no history of claiming in the database. Adults with at least 1 year of prescription history available and claiming their first prescription for an antihyperglycemic drug during the analysis period were classified as newly diagnosed with T2D.
RESULTS: A similar number of people had at least 1 non-insulin antihyperglycemic prescription during the baseline, prepandemic, and pandemic periods in Canada (1,778,155, 1,822,403, and 1,797,272, respectively). However, the number of people initiating newer antihyperglycemic medications decreased at the beginning of the pandemic, in contrast to older medications, which remained consistent across the pandemic period. The number of people diagnosed with T2D decreased in the early months of the pandemic but recovered by October 2020.
CONCLUSIONS: The COVID-19 epidemic in Canada impacted clinical care for at-risk Canadians, with fewer being prescribed newer antihyperglycemic drugs and a reduction in the number of diagnoses of T2D.
METHODS: This was a retrospective cross-sectional study of prescription patterns of antihyperglycemic medications claimed by individuals with type 2 diabetes (T2D) before and during the COVID-19 pandemic using the IQVIA Canada Longitudinal Prescription Claims database. The study period was from March 1, 2018, to February 28, 2021. The study outcomes are described on a monthly, quarterly, and yearly basis and overall, and by medication, medication class, and insurance coverage type. \"New-to-molecule\" patients were defined as those claiming a medication during the analysis period that they had no history of claiming in the database. Adults with at least 1 year of prescription history available and claiming their first prescription for an antihyperglycemic drug during the analysis period were classified as newly diagnosed with T2D.
RESULTS: A similar number of people had at least 1 non-insulin antihyperglycemic prescription during the baseline, prepandemic, and pandemic periods in Canada (1,778,155, 1,822,403, and 1,797,272, respectively). However, the number of people initiating newer antihyperglycemic medications decreased at the beginning of the pandemic, in contrast to older medications, which remained consistent across the pandemic period. The number of people diagnosed with T2D decreased in the early months of the pandemic but recovered by October 2020.
CONCLUSIONS: The COVID-19 epidemic in Canada impacted clinical care for at-risk Canadians, with fewer being prescribed newer antihyperglycemic drugs and a reduction in the number of diagnoses of T2D.
摘要：
背景：糖尿病是加拿大的主要公共卫生问题，需要多因素，一致的临床管理。COVID-19大流行增加了许多慢性病管理方面的挑战，包括糖尿病.在COVID-19的背景下，糖尿病与更高的严重疾病风险相关。大流行限制也影响了糖尿病护理的连续性，这可能导致糖尿病相关并发症和死亡率的风险增加。
方法：这是一项回顾性横断面研究，使用IQVIA加拿大纵向处方索赔数据库，对COVID-19大流行之前和期间2型糖尿病（T2D）患者声称的抗高血糖药物的处方模式进行了回顾性研究。研究期间为2018年3月1日至2021年2月28日。研究结果每月进行一次描述，季度,以及总体和药物治疗的年度基础，药物类别和保险范围类型。新分子患者被定义为在分析期间声称药物的患者，他们在数据库中没有声称的历史。具有至少一年的处方史的成年人，在分析期间声称他们的第一个抗高血糖药物处方被分类为新诊断为T2D。
结果：相似数量的人在基线时至少服用了一种非胰岛素降糖药，大流行前，和加拿大的大流行期（分别为1,778,155；1,822,403；和1,797,272）。然而,在大流行开始时，开始使用新的抗高血糖药物的人数减少了，与在整个大流行期间保持一致的较旧药物相反。在大流行的最初几个月，诊断为T2D的人数有所减少，但到2020年10月恢复。
结论：加拿大的COVID-19流行影响了高危加拿大人的临床护理，减少了新的抗高血糖药物的处方，并减少了T2D的诊断。
方法：这是一项回顾性横断面研究，使用IQVIA加拿大纵向处方索赔数据库，对COVID-19大流行之前和期间2型糖尿病（T2D）患者声称的抗高血糖药物的处方模式进行了回顾性研究。研究期间为2018年3月1日至2021年2月28日。研究结果每月进行一次描述，季度,以及总体和药物治疗的年度基础，药物类别和保险范围类型。新分子患者被定义为在分析期间声称药物的患者，他们在数据库中没有声称的历史。具有至少一年的处方史的成年人，在分析期间声称他们的第一个抗高血糖药物处方被分类为新诊断为T2D。
结果：相似数量的人在基线时至少服用了一种非胰岛素降糖药，大流行前，和加拿大的大流行期（分别为1,778,155；1,822,403；和1,797,272）。然而,在大流行开始时，开始使用新的抗高血糖药物的人数减少了，与在整个大流行期间保持一致的较旧药物相反。在大流行的最初几个月，诊断为T2D的人数有所减少，但到2020年10月恢复。
结论：加拿大的COVID-19流行影响了高危加拿大人的临床护理，减少了新的抗高血糖药物的处方，并减少了T2D的诊断。
