Evidence map›Paper›PMID 35606162›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2022

Newer long-acting insulin prescriptions for patients with type 2 diabetes: prevalence and practice variation in a retrospective cohort study.

Marloes Dankers, Karin Hek, Marjorie Nelissen-Vrancken, Sebastiaan T Houweling, Aukje Mantel-Teeuwisse, Liset van Dijk

Open access · hybridAbstract read
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 2 countries.

Marloes DankersDutch Institute for Rational Use of Medicine, Utrecht, and PhD student, Department of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, Faculty of Science and Engineering, University of Groningen, Groningen.ORCID 0000-0003-0971-8388
Karin HekNivel, Netherlands Institute for Health Services Research, Utrecht.ORCID 0000-0001-9551-1564
Marjorie Nelissen-VranckenDutch Institute for Rational Use of Medicine, Utrecht.
Sebastiaan T HouwelingGeneral Practice Sleeuwijk, Sleeuwijk.
Aukje Mantel-TeeuwisseDivision of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht.ORCID 0000-0002-8782-0698
Liset van DijkNivel, Netherlands Institute for Health Services Research, Utrecht, and honorary professor, pharmacy health services research, Department of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, Faculty of Science and Engineering, University of Groningen, Groningen.ORCID 0000-0003-3277-4740
University of Groningen · NLInstituut voor Verantwoord Medicijngebruik · NLNetherlands Institute for Health Services Research · NLPharmo Institute · NLSleep Research Society · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLittle is known about prescription patterns of expensive non-recommended newer long-acting insulins (glargine 300 U/mL and degludec) for patients with type 2 diabetes mellitus (T2DM).

aimTo identify practice variation in, and practice- and patient-related characteristics associated with, the prescription of newer long-acting insulins to patients with T2DM in primary care. DESIGN AND

settingA retrospective cohort study in Dutch general practices (Nivel Primary Care Database).

methodA first prescription for intermediate or long-acting insulins in 2018 was identified in patients aged ≥40 years using other T2DM drugs. Per practice, the median percentage and interquartile range (IQR) of patients with newer insulin prescriptions were calculated. Multilevel logistic regression models were constructed to calculate intraclass correlation coefficients (ICCs) and quantify the association of patient and practice characteristics with prescriptions for newer insulins (odds ratios [ORs] and 95% confidence intervals [CIs]).

resultsIn total, 7757 patients with prescriptions for intermediate or long-acting insulins from 282 general practices were identified. A median percentage of 21.2% (IQR 12.5-36.4%) of all patients prescribed intermediate or long-acting insulins per practice received a prescription for newer insulins. After multilevel modelling, the ICC decreased from 20% to 19%. Female sex (OR 0.77, 95% CI = 0.69 to 0.87), age ≥86 years compared with 40-55 years (OR 0.22, 95% CI = 0.15 to 0.34), prescriptions for metformin (OR 0.66, 95% CI = 0.53 to 0.82), sulfonylurea (OR 0.58, 95% CI = 0.51 to 0.66), or other newer T2DM drugs (OR 3.10, 95% CI = 2.63 to 3.66), and dispensing practices (OR 1.78, 95% CI = 1.03 to 3.10) were associated with the prescription of newer insulins.

conclusionThe inter-practice variation in the prescription of newer insulins is large and could only be partially explained by patient- and practice-related differences. This indicates substantial opportunities for improvement.

Indexed as

Diabetes Mellitus, Type 2InsulinsFemaleHumansHypoglycemic AgentsInsulinInsulin, Long-ActingPrescriptionsPrevalenceRetrospective StudiesHypoglycemic AgentsInsulinInsulin, Long-ActingInsulinsdiabetes mellitusinsulinpractice variationprimary health care

Identifiers

PMID35606162
PMCPMC9172218
OpenAlexW4220768745

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.