Pharmaceutical management of type 2 diabetes among Indigenous Australians living in urban or rural locations: a comparative study using a national general practice database.
Adult
Female
Humans
Male
Middle Aged
Australia
/ epidemiology
Australian Aboriginal and Torres Strait Islander Peoples
/ statistics & numerical data
Cross-Sectional Studies
Diabetes Mellitus, Type 2
/ drug therapy
General Practice
/ statistics & numerical data
Health Services, Indigenous
/ supply & distribution
Hypoglycemic Agents
/ therapeutic use
Urban Population
/ statistics & numerical data
Rural Population
/ statistics & numerical data
diabetes mellitus
general practice
indigenous peoples
medication therapy management
rural population
Journal
The Australian journal of rural health
ISSN: 1440-1584
Titre abrégé: Aust J Rural Health
Pays: Australia
ID NLM: 9305903
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
revised:
17
07
2023
received:
21
03
2023
accepted:
06
08
2023
medline:
23
10
2023
pubmed:
25
8
2023
entrez:
25
8
2023
Statut:
ppublish
Résumé
Type 2 diabetes is more prevalent among Aboriginal and Torres Strait Islander Peoples, especially those living in rural than urban areas. However, little is known about how diabetes is managed in different settings. To investigate differences in the prevalence of diabetes and the prescription of antidiabetic medications for Aboriginal and/or Torres Strait Islander Peoples living in urban or rural Australia. Cross-sectional study using de-identified electronic medical records of 29,429 Aboriginal and/or Torres Strait Islander adults (60.4% females; mean age 45.2 ± 17.3 years) regularly attending 528 'mainstream' Australian general practices (MedicineInsight) in 2018. The prevalence of diabetes was 16.0%, and it was more frequent among those living in rural areas (22.0; 95% CI 19.3-24.4) than inner regional (17.6%; 95% CI 16.0-19.2) or major cities (15.8%; 95% CI 14.7-17.0; p < 0.001). The highest prevalence of diabetes was for males living in rural settings (25.0%). Of those with diabetes, 71.6% (95% CI 69.0-74.0) were prescribed antidiabetics, with a similar frequency in urban and rural areas (p = 0.291). After adjustment for sociodemographics, the only difference in diabetes management was a higher prescription of sulfonylureas in rural areas than in major cities (OR 1.39; 1.07-1.80). The prevalence of diabetes was similar to other national data, although we found it was more frequent amongst Aboriginal and/or Torres Strait Islander males, especially those from rural areas. Despite current recommendations, one-in-four Indigenous Australians with diabetes were not prescribed antidiabetics. The clinical significance of more frequent prescriptions of sulfonylureas in rural locations remains unclear.
Substances chimiques
Hypoglycemic Agents
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Pagination
979-990Subventions
Organisme : Australian College of Rural and Remote Medicine
Informations de copyright
© 2023 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
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