目的：掌握真实世界中初始使用胰高血糖素样肽-1受体激动剂(Glucagon-like Peptide-1 Receptor Agonists，GLP-1 RAs)的2型糖尿病患者的基本特征和用药模式。方法：基于2015-2019年间天津市10家三级医院的信息系统数据库，通过疾病诊断与药品处方信息识别2016-2018年间初始使用 GLP-1类药物的2型糖尿病患者。分别统计入组患者的基线特征及随访期间的用药模式，包括用药依从性、持续性、平均日剂量以及联合用药情况等。结果：研究共识别到初始使用GLP-1类药物的患者1705 人，由于利拉鲁肽使用者占95%以上，为保证样本人群的同质性，仅纳入利拉鲁肽用药患者1624人。患者入组时的平均年龄为52.5±12.8岁，男性占比56.8%。患者在入组后一年内使用GLP-1类药物的依从性(处方覆盖天数比例)为0.54，依从性好、依从性一般和依从性差的患者比例分别为35.4%、21.2%和 43.5%；患者平均持续用药天数为201.9±170.0天，在入组后一年内停止用药的患者比例为49.3%；平均日剂量为0.70 mg·d-1；有46.7%的患者在GLP-1类药物基础上联合使用其他降糖药。结论：在中国2型糖尿病患者中，GLP-1类药物的用药依从性有待提高，应加强糖尿病患者特别是心脑血管疾病高危人群的用药教育和管理，以提高患者对药品使用的依从性。
Objective: To evaluate treatment patterns of Glucagon-like peptide-1 receptor agonist (GLP-1 RA) among Chinese patients with Type 2 Diabetes Mellitus (T2DM). Methods: Data were collected from the hospital information system database covering 10 tertiary hospitals in Tianjin, China. Adult patients with T2DM who initiated GLP-1 RAs between January 1, 2016 and December 31, 2018 were identifi ed by using ICD-10 codes and Chinese characters. Treatment patterns were assessed by the adherence, persistence, mean daily dose, and combination use with other anti-diabetes therapy over the 12-month follow-up period. Results: A total of 1705 patients initially treated with GLP-1 RAs were identifi ed. Only the Liraglutide users (N=1624) were enrolled, in order to ensure the homogeneity of patients. The mean age of identifi ed patients was 52.5±12.8 years, and 56.8% were male. The adherence of GLP-1 RAs (proportion of days covered, PDC) was 0.54; proportions of patients with good, intermediate, and poor adherence were 35.4%, 21.2% and 43.5%, respectively; the mean number of days that patient received GLP-1 RAs continuously was 201.9±170.0 days; and discontinuation occurred among 49.3% patients during 1-year follow-up. The mean daily dose among patients persisting on GLP-1 RAs was 0.70mg·d-1 during one year follow-up. 46.7% of patients used GLP-1RAs in combination with other antidiabetes therapy. Conclusion: The adherence of GLP-1 RAs treatment in Chinese patients with type 2 diabetes need to be improved. To increase the treatment adherence, it’s necessary to strengthen the medication education and management for diabetic patients, especially for those under high risk of cardiovascular and cerebrovascular diseases.
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