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dc.contributor.authorGreiver, Michelle
dc.contributor.authorHavard, Alys
dc.contributor.authorKuster Filipe Bowles, Juliana
dc.contributor.authorKalia, Sumeet
dc.contributor.authorChen, Tao
dc.contributor.authorAliarzadeh, Babak
dc.contributor.authorMoineddin, Rahim
dc.contributor.authorSherlock, Julian
dc.contributor.authorHinton, William
dc.contributor.authorSullivan, Francis
dc.contributor.authorO'Neill, Braden
dc.contributor.authorPow, Conrad
dc.contributor.authorBhatt, Aashka
dc.contributor.authorRahman, Fahrurrozi
dc.contributor.authorMeza-Torres, Bernardo
dc.contributor.authorLitchfield, Melisa
dc.contributor.authorde Lusignan, Simon
dc.identifier.citationGreiver , M , Havard , A , Kuster Filipe Bowles , J , Kalia , S , Chen , T , Aliarzadeh , B , Moineddin , R , Sherlock , J , Hinton , W , Sullivan , F , O'Neill , B , Pow , C , Bhatt , A , Rahman , F , Meza-Torres , B , Litchfield , M & de Lusignan , S 2021 , ' Trends in diabetes medication use in Canada, England, Scotland and Australia : a repeated cross-sectional analysis (2012-2017) ' , British Journal of General Practice , vol. 71 , no. 704 , pp. e209-e218 .
dc.identifier.otherPURE: 272219218
dc.identifier.otherPURE UUID: 23492ef8-6be2-47df-b2b4-fef22b2e4a2f
dc.identifier.otherScopus: 85102268844
dc.identifier.otherWOS: 000623806500006
dc.identifier.otherPubMed: 33619050
dc.identifier.otherORCID: /0000-0002-5918-9114/work/94669260
dc.identifier.otherORCID: /0000-0002-6623-4964/work/94669868
dc.descriptionFunding: This study was supported by Diabetes Action Canada which is funded, in part, through a Canadian Institutes of Health Research chronic disease network grant under the Strategy for Patient-Oriented Research (Funding Reference number: SCA 145101). Dr Greiver is supported through the Gordon F. Cheesbrough Research Chair in Family and Community Medicine from North York General Hospital. Acquisition of the PBS 10% sample data was supported by a NHMRC Centre of Research Excellence Grant (#1060407) and a Cooperative Research Centre Project Grant from the Australian Department of Industry, Innovation and Science (CRC-P-439). AH was supported by a NSW Health Early-Mid Career Fellowship.en
dc.description.abstractBackground: Several new classes of glucose lowering medications have been introduced in the past two decades. Some, such as Sodium-glucose cotransporter 2 inhibitors (SGLT2s), have evidence of improved cardiovascular outcomes, while others, such as Dipeptidyl peptidase-4 inhibitors (DPP4s), do not. It is therefore important to identify their uptake, in order to find ways to support the use of more effective medications. Aims: We studied the uptake of these new classes amongst patients with type 2 diabetes. Design and setting: Retrospective repeated cross-sectional analysis. We compared rates of medication uptake in Australia, Canada, England and Scotland. Method: We used primary care Electronic Medical Data on prescriptions (Canada, UK) and dispensing data (Australia) from 2012 to 2017. We included persons aged 40 years or over on at least one glucose-lowering drug class in each year of interest, excluding those on insulin only. We determined proportions of patients in each nation, for each year, on each class of medication, and on combinations of classes. Results: By 2017, data from 238,609 patients were included. The proportion of patients on sulfonylureas (SUs) decreased in three out of four nations, while metformin decreased in Canada. Use of combinations of metformin and new drug classes increased in all nations, replacing combinations involving SUs. In 2017 more patients were on DPP4s (between 19.1% and 27.6%) than on SGLT2s (between 10.1% and 15.3%). Conclusions: New drugs are displacing SUs. However, despite evidence of better outcomes, the adoption of SGLT2s lagged behind DPP4s.
dc.relation.ispartofBritish Journal of General Practiceen
dc.rightsCopyright © 2021 The Authors. This article is Open Access: CC BY 4.0 licence (
dc.subjectPrimary healthcareen
dc.subjectDiabetes mellitus, Type 2en
dc.subjectDrug Therapyen
dc.subjectElectronic health recordsen
dc.subjectQA75 Electronic computers. Computer scienceen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectRM Therapeutics. Pharmacologyen
dc.subjectZA4050 Electronic information resourcesen
dc.titleTrends in diabetes medication use in Canada, England, Scotland and Australia : a repeated cross-sectional analysis (2012-2017)en
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. School of Computer Scienceen
dc.contributor.institutionUniversity of St Andrews. Sir James Mackenzie Institute for Early Diagnosisen
dc.contributor.institutionUniversity of St Andrews. Population and Behavioural Science Divisionen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.description.statusPeer revieweden

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