Prescription Patterns and Disease Control in Type 2 Diabetes Mellitus Patients in Nursing Home and Home Care Settings: A Retrospective Analysis in Germany

Abstract

Aim: The aim of this study was to analyze prescription patterns and disease control in patients with type 2 diabetes mellitus (T2DM) in nursing home and home care settings in Germany. Methods: The present study is based on data from the Disease Analyzer database (QuintilesIMS). Patients with an initial diagnosis of T2DM and documented HbA1c values between January 2011 and December 2015 were included in the analysis. The index date corresponded to the last documented HbA1c value. Patients in nursing homes were matched (1:1) with patients living at home based on age, gender, and dementia diagnosis. The first outcome of the study was the share of use of several antidiabetic drugs in the two different settings. The second outcome was the mean HbA1c value and the proportion of patients with HbA1c values lower than 7% in the two different groups. Results: In this study, 4925 individuals lived in nursing homes and 4925 individuals lived at home. The mean age was 80.7 years (SD = 7.7). Prescription patterns differed significantly between nursing home and home care settings: insulin (57.9% vs 41.1%), metformin (46.6% vs 60.5%), sulfonylurea (24.9% vs 34.2%), DPP4 inhibitors (13.4% vs 19.8%), and other antihyperglycemic drugs (7.8% vs 12.1%). In contrast, mean HbA1c values (nursing home: 7.2%; home: 7.2%) and the share of patients with Hb1Ac values lower than 7% (nursing home: 49.1%; home: 50.9%) did not differ significantly between the two groups. Conclusion: Overall, the differences in prescription patterns between nursing homes and home care were not associated with significant differences in the management of T2DM.