PT  - JOURNAL ARTICLE
AU  - Michelle Greiver
AU  - Alys Havard
AU  - Juliana KF Bowles
AU  - Sumeet Kalia
AU  - Tao Chen
AU  - Babak Aliarzadeh
AU  - Rahim Moineddin
AU  - Julian Sherlock
AU  - William Hinton
AU  - Frank Sullivan
AU  - Braden O’Neill
AU  - Conrad Pow
AU  - Aashka Bhatt
AU  - Fahurrozi Rahman
AU  - Bernardo Meza-Torres
AU  - Melisa Litchfield
AU  - Simon de Lusignan
TI  - Trends in diabetes medication use in Australia, Canada, England, and Scotland: a repeated cross-sectional analysis in primary care
AID  - 10.3399/bjgp20X714089
DP  - 2021 Mar 01
TA  - British Journal of General Practice
PG  - e209--e218
VI  - 71
IP  - 704
4099  - http://bjgp.org/content/71/704/e209.short
4100  - http://bjgp.org/content/71/704/e209.full
SO  - Br J Gen Pract2021 Mar 01; 71
AB  - Background 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 treatments.Aim To analyse the uptake of these new classes among patients with type 2 diabetes.Design and setting This was a retrospective repeated cross-sectional analysis in primary care. Rates of medication uptake in Australia, Canada, England, and Scotland were compared.Method Primary care Electronic Medical Data on prescriptions (Canada, UK) and dispensing data (Australia) from 2012 to 2017 were used. Individuals aged ≥40 years on at least one glucose-lowering drug class in each year of interest were included, excluding those on insulin only. Proportions of patients in each nation, for each year, on each class of medication, and on combinations of classes were determined.Results Data from 238 619 patients were included in 2017. 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%).Conclusion New drugs are displacing SUs. However, despite evidence of better outcomes, the adoption of SGLT2s lagged behind DPP4s.