Abstract
BackgroundComorbidity in patients with diabetes is associated with poorer health and increased cost. The aim of this study was to investigate the prevalence and ingredient cost of comorbidity in patients ≥ 65 years with and without medication treated type 2 diabetes using a national pharmacy claims database.MethodsThe Irish Health Service Executive Primary Care Reimbursement Service pharmacy claims database, which includes all prescribing to individuals covered by the General Medical Services scheme, was used to identify the study population (≥ 65 years). Patients with medication treated type 2 diabetes (T2DM) were identified using the prescription of oral anti-hyperglycaemic agents alone or in combination with insulin as a proxy for disease diagnosis. The prevalence and ingredient prescribing cost of treated chronic comorbidity in the study population with and without medication treated T2DM were ascertained using a modified version of the RxRiskV index, a prescription based comorbidity index. The association between T2DM and comorbid conditions was assessed using logistic regression adjusting for age and sex. Bootstrapping was used to ascertain the mean annual ingredient cost of treated comorbidity. Statistical significance at p < 0.05 was assumed.ResultsIn 2010, 43165 of 445180 GMS eligible individuals (9.7%) were identified as having received medication for T2DM. The median number of comorbid conditions was significantly higher in those with T2DM compared to without (median 5 vs. 3 respectively; p < 0.001). Individuals with T2DM were more likely to have ≥ 5 comorbidities when compared to those without (OR = 2.82, 95% CI = 2.76-2.88, p < 0.0001). The mean annual ingredient cost for comorbidity was higher in the study population with T2DM (€1238.67, 95% CI = €1238.20 - €1239.14) compared to those without the condition (€799.28, 95% CI = €799.14 - € 799.41).ConclusionsIndividuals with T2DM were more likely to have a higher number of treated comorbid conditions than those without and this was associated with higher ingredient costs. This has important policy and economic consequences for the planning and provision of future health services in Ireland, given the expected increase in T2DM and other chronic conditions.
Highlights
Comorbidity in patients with diabetes is associated with poorer health and increased cost
The aim of this study was to investigate and estimate the prevalence, type and ingredient cost of chronic comorbid conditions occurring in elderly Irish individuals with T2DM, compared to those without T2DM, using a modified version of the RxRisk V comorbidity index, based on data obtained from a national pharmacy claims database
In the study population 43165 individuals received three or more consecutive prescriptions for oral anti-hyperglycaemic (OAH) agents. This represents a prevalence of 9.7% for T2DM in this elderly population
Summary
Comorbidity in patients with diabetes is associated with poorer health and increased cost. The prevalence of diabetes has increased globally [2] and it is projected that worldwide the prevalence will increase from an estimated 2.8% in the year 2000 to 4.8% by 2030 [3]. The original paper classified chronic comorbid conditions as being either concordant or discordant with diabetes. Concordant conditions are those associated with diabetes, i.e. they represent part of the same overall pathophysiological risk profile and share the same medical management plan (e.g. hypertension, ischemic heart disease, and hyperlipidemia) [9,10]. Discordant conditions are not pathophysiologically associated with diabetes and their management may be different (e.g. arthritis, chronic obstructive pulmonary disease, depression) [9,10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
