(DCP032) COEXISTING TREATMENTS IN PRESCRIPTION RECORDS OF CARDIOMETABOLIC PATIENTS

Background: Type 2 diabetes can lead to a variety of life-threatening complications, including stroke, blindness, and amputations. Diabetes treatment rates among pharmacy customers ranges from 7% in British Columbia to 11% in Nova Scotia, while hypertension treatment rates range from 18% in British Columbia to 27% in Nova Scotia. Here, we compare multimorbidity burdens among cardiometabolic patients (patients taking prescription medications for diabetes, hypertension or dyslipidemia) as a first step towards mapping patient journeys and health outcome risks in large cohorts of pharmacy patients.

Objectives:
Develop an analytic framework for coexisting medical conditions from vast retrospective prescription data. Long term benefit of this analytical framework would be better understanding of access to healthcare and complication risks among cardiometabolic patients.

METHODS AND RESULTS: A retrospective registry of about seven million anonymized cardiometabolic patients is distilled from ten years of dispensing data extracted from 1,905 pharmacies across Canada. In recent years, volumes of patients initiating hypertension treatment are stable, while volumes of patients initiating diabetes treatment are growing rapidly at 20% annual growth across all provinces in Canada. Age and sex adjusted comorbidity prevalence rates per year and geographical unit are calculated as a frequency of hypertension or dyslipidemia prescriptions among diabetic patients. The rate of hypertension treatment among pharmacy patients with diabetes is 60%, consistent with a 58% self-reported hypertension rate among type 2 diabetes patients in the Canadian Community Health Survey (CCHS, 2018). Conversely, the rate of diabetes treatment among patients taking hypertension medication is 24%, also consistent with a 22% rate reported in the CCHS survey. Most patients taking diabetes and hypertension prescriptions at any time during the duration of this study have started hypertension treatment before (53%) or simultaneously (13%) with diabetes treatment. Importantly, patients treated for both diabetes and hypertension are starting diabetes treatment at an older age (mean age of 60), while patients treated for diabetes exclusively are much younger (mean age of 45). In addition, patients with hypertension and diabetes prescription records were mostly male (51%), while patients with diabetes prescription and without any hypertension prescription records were mostly female (61%).

Conclusion: This study highlights the value of prescription dispensing data for gaining insights about patient demographics, disease progression, and clinical practices in cardiometabolic conditions.