Pharmaceutical management of type 2 diabetes among Indigenous Australians living in urban or rural locations: a comparative study using a national general practice database.

Publisher: Wiley-Blackwell Publishing Asia Country of Publication: Australia NLM ID: 9305903 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1440-1584 (Electronic) Linking ISSN: 10385282 NLM ISO Abbreviation: Aust J Rural Health

Publication: Amidale : Wiley-Blackwell Publishing Asia
Original Publication: Armidale : Association for Australian Rural Nurses, c1992-

Australian Aboriginal and Torres Strait Islander Peoples*/statistics & numerical data ; Diabetes Mellitus, Type 2*/drug therapy ; Diabetes Mellitus, Type 2*/epidemiology ; Diabetes Mellitus, Type 2*/ethnology ; General Practice*/statistics & numerical data ; Health Services, Indigenous*/supply & distribution ; Hypoglycemic Agents*/therapeutic use; Adult ; Female ; Humans ; Male ; Middle Aged ; Australia/epidemiology ; Cross-Sectional Studies ; Urban Population/statistics & numerical data ; Rural Population/statistics & numerical data

Introduction: Type 2 diabetes is more prevalent among Aboriginal and Torres Strait Islander Peoples, especially those living in rural than urban areas. However, little is known about how diabetes is managed in different settings.
Objective: To investigate differences in the prevalence of diabetes and the prescription of antidiabetic medications for Aboriginal and/or Torres Strait Islander Peoples living in urban or rural Australia.
Design: Cross-sectional study using de-identified electronic medical records of 29,429 Aboriginal and/or Torres Strait Islander adults (60.4% females; mean age 45.2 ± 17.3 years) regularly attending 528 'mainstream' Australian general practices (MedicineInsight) in 2018.
Findings: The prevalence of diabetes was 16.0%, and it was more frequent among those living in rural areas (22.0; 95% CI 19.3-24.4) than inner regional (17.6%; 95% CI 16.0-19.2) or major cities (15.8%; 95% CI 14.7-17.0; p < 0.001). The highest prevalence of diabetes was for males living in rural settings (25.0%). Of those with diabetes, 71.6% (95% CI 69.0-74.0) were prescribed antidiabetics, with a similar frequency in urban and rural areas (p = 0.291). After adjustment for sociodemographics, the only difference in diabetes management was a higher prescription of sulfonylureas in rural areas than in major cities (OR 1.39; 1.07-1.80).
Discussion: The prevalence of diabetes was similar to other national data, although we found it was more frequent amongst Aboriginal and/or Torres Strait Islander males, especially those from rural areas.
Conclusion: Despite current recommendations, one-in-four Indigenous Australians with diabetes were not prescribed antidiabetics. The clinical significance of more frequent prescriptions of sulfonylureas in rural locations remains unclear.
(© 2023 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

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Australian College of Rural and Remote Medicine

Keywords: diabetes mellitus; general practice; indigenous peoples; medication therapy management; rural population

0 (Hypoglycemic Agents)

Date Created: 20230825 Date Completed: 20231128 Latest Revision: 20231128

20250114

10.1111/ajr.13032

37622661