[Regional Trends in Antidiabetic Drug Prescribing in Portugal: Eight Years of Nationwide Real-World Evidence (2017 - 2024) (TREND-8 REGIONS Study)].

چکیده اصلی

INTRODUCTION: The nationwide TREND-8 study revealed significant changes in antidiabetic prescribing patterns in Portugal between 2017 and 2024, with marked increases in the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA). The aim of the TREND-8 REGIONS study was to analyze variations across regions and healthcare settings. METHODS: This nationwide, cross-sectional, retrospective study analyzed antidiabetic drug prescriptions in Portugal between 2017 and 2024, stratified by healthcare setting (primary care, public hospitals, and private institutions) and geographic region (North, Center, Lisbon, Alentejo, Algarve, Madeira, and the Azores). RESULTS: Biguanides remained the most prescribed antidiabetic class across all regions, despite there being a uniform national decline in the proportion of prescriptions (2.3%/year), accounting for 37.5% of prescriptions in 2024. Insulin prescriptions showed a proportional decline across all regions (-5.3%/year), representing 7.5% of prescriptions in 2024, with significantly lower proportions in Madeira (5.5%; p < 0.001). The SGLT2i class exhibited the largest increase (34.5%/year), with modest regional variation. It accounted for 29.3% of total prescriptions in 2024; lower proportions were observed in Alentejo (27.5%; p = 0.002). The GLP-1RA class showed the second highest increase (24.1%/year), more pronounced in Alentejo (34.4%/year; p < 0.001) and Azores (38.4%/year; p < 0.001), accounting for 4.9% of prescriptions in 2024. Their proportion was higher in the Azores (7.1%) and Lisbon (5.6%) and lower in Alentejo (4.0%), Center (4.3%), and Madeira (4.4%) (all p < 0.05). Across healthcare settings, GLP-1RA prescribing increased more in primary care (32.0%/year), although the highest proportion of prescribing was observed in private institutions (10.4% of prescriptions in 2024). The greatest increase in SGLT2i prescribing occurred in primary care (35.4%/year), while public hospitals accounted for the highest proportion of prescriptions (34.5%) in 2024. CONCLUSION: The TREND-8 REGIONS study showed an evolution that is consistent with international recommendations across the different regions of Portugal and healthcare settings analyzed, with only slight variability observed in GLP‑1 RA prescribing.

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