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. 2024 Mar 3:13:100429.
doi: 10.1016/j.rcsop.2024.100429. eCollection 2024 Mar.

Rurality is associated with lower likelihood of dipeptidyl peptidase 4 inhibitor use for treatment intensification

Danielle K Nagy  1 , Lauren C Bresee  2 , Dean T Eurich  3 , Scot H Simpson  4
Affiliations

Rurality is associated with lower likelihood of dipeptidyl peptidase 4 inhibitor use for treatment intensification

Danielle K Nagy et al. Explor Res Clin Soc Pharm. .

Abstract

Background: Antihyperglycemic drug utilization studies are conducted frequently and describe the uptake of new drug therapies across may jurisdictions. An increasingly important, yet often absent, aspect of these studies is the impact of rurality on drug utilization.

Objectives: The objective of this study was to explore the association between place of residence (rural, urban, metropolitan) and the use of dipeptidyl peptidase 4 inhibitors (DPP-4i) for first treatment intensification of type 2 diabetes.

Methods: A retrospective cohort study was conducted from April 1, 2008 to March 31, 2019 of new metformin users. A multivariable logistic regression analysis was performed to determine the association between place of residence (using postal codes) and likelihood of DPP-4i dispensing.

Results: After adjusting for confounders, analysis revealed that rural-dwellers are less likely to have a DPP-4i dispensed, compared with metropolitan-dwellers (aOR:0.64; 95%CI:0.61-0.67) and over-time, the uptake in rural areas was slower.

Conclusions: This study demonstrates that rurality can have an impact on drug therapy decisions at first treatment intensification, with respect to the utilization of new therapies.

Keywords: Dipeptidyl peptidase 4 inhibitor; Residence; Rural-urban continuum; Treatment intensification; Type 2 diabetes.

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Conflict of interest statement

No potential conflicts of interest relevant to this article were reported. S.H.S. is supported as the Chair in Patient Health Management, jointly held by the Faculty of Pharmacy and Pharmaceutical Sciences and Faculty of Medicine and Dentistry, University of Alberta. This study is based in part on data provided by Alberta Health. The interpretation and conclusions contained herein are those of the researchers and do not necessarily represent the views of the Government of Alberta. Neither the Government of Alberta nor Alberta Health express any opinion in relation to this study.

Figures

Fig. 1
Fig. 1
Dipeptidyl peptidase 4 inhibitor (DPP-4i) dispensations over time across the rural-urban continuum. White bars = metropolitan; grey bars = urban; black bars = rural.
See this image and copyright information in PMC

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