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

• Published in: Exploratory research in clinical and social pharmacy Vol. 13; p. 100429
• Main Authors: Nagy, Danielle K., Bresee, Lauren C., Eurich, Dean T., Simpson, Scot H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2024; Elsevier
• Subjects: Dipeptidyl peptidase 4 inhibitor; Residence; Rural-urban continuum; Treatment intensification; Type 2 diabetes; Type 2 diabetes; Treatment intensification; Rural-urban continuum; Dipeptidyl peptidase 4 inhibitor; Residence
• ISSN: 2667-2766; 2667-2766
• DOI: 10.1016/j.rcsop.2024.100429

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.
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.
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.
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.
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.