DRUG PRESCRIPTION IN DIABETIC-PATIENTS IN STOCKHOLM IN 1992 AND 1995 - CHANGE OVER TIME

Objective: To describe and compare the distribution of prescribed drug s in diabetic patients between 1992 and 1995. Methods: Two cross-secti onal surveys of a random selection of medical records of diabetic pati ents, from three community health centres (CHCs) in the Stockholm metr opolitan area, were carried out. The age of the subjects ranged from 2 0 to 84 years. The number of prescriptions of pharmaceutical preparati ons given to the diabetic patients was noted, as well as classificatio n of the diabetes, the metabolic outcome, and concomitant hypertension . Results: Between 1992 and 1995, the use of oral antidiabetics increa sed significantly from 43 to 57% of the patients and the rate of treat ment with diet only decreased from 30 to 20%. Combination treatment wi th oral drugs and insulin rose significantly from 1 to 8% of the patie nts. However, the greatest increase observed between 1992 and 1995 con cerns cardiovascular drugs. The prescription rate of ACE inhibitors in creased from 5 to 21%, of loop diuretics from 19 to 28%, of ASA from 9 to 21%, and of lipid-lowering agents from 1 to 7%. There was also a c onsiderable variation between the three CHCs. Despite the more aggress ive diabetic treatment strategies, the metabolic state was unchanged a nd unsatisfactory for 40-50% of the patients. Conclusions: There have been major changes towards more active pharmacological treatment regar ding antidiabetic, cardiovascular, and lipid-lowering agents.