David P Nau1, Usha Mallya. 1. Center for Medication Use, Policy and Economics, Department of Social and Administrative Sciences, University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI 48109-1065, USA. dnau@umich.edu
Abstract
OBJECTIVE: To determine whether there were sex-related differences in the management of dyslipidemia among managed care enrollees with diabetes mellitus. STUDY DESIGN AND METHODS: Retrospective analyses were conducted using medical and pharmacy claims data from a health maintenance organization during 2000 and 2001. Patients with type 2 diabetes mellitus were identified through a validated algorithm of medication and diagnosis codes. Chi-squared analysis was used to determine if women were less likely than men to receive a lipid test or a lipid-modifying drug. Logistic regression models were constructed to compare sex-related differences while controlling for age, cardiovascular disease diagnosis, and 2 proxies of illness severity (hospitalization in 2000 and the intensity of diabetes mellitus drug therapy). RESULTS: During 2000 and 2001, 79.4% of women received a lipid test compared with 84.2% of men (chi2 = 6.69, P = .01). Also, 33.2% of women received a lipid-modifying drug compared with 45.5% of men (chi2 = 27.31, P < .01). Logistic regression analysis revealed that men were more likely than women to receive a lipid test when controlling for age, cardiovascular disease diagnosis, and illness severity (odds ratio [OR], 1.45; 95% confidence interval, 1.13-1.81). Men were also more likely than women to receive a lipid-modifying drug when controlling for age, cardiovascular disease diagnosis, illness severity, and lipid testing (OR, 1.51; 95% confidence interval, 1.22-1.86). CONCLUSION: Women with type 2 diabetes mellitus were less likely than men with type 2 diabetes mellitus to receive lipid tests or lipid-modifying drugs.
OBJECTIVE: To determine whether there were sex-related differences in the management of dyslipidemia among managed care enrollees with diabetes mellitus. STUDY DESIGN AND METHODS: Retrospective analyses were conducted using medical and pharmacy claims data from a health maintenance organization during 2000 and 2001. Patients with type 2 diabetes mellitus were identified through a validated algorithm of medication and diagnosis codes. Chi-squared analysis was used to determine if women were less likely than men to receive a lipid test or a lipid-modifying drug. Logistic regression models were constructed to compare sex-related differences while controlling for age, cardiovascular disease diagnosis, and 2 proxies of illness severity (hospitalization in 2000 and the intensity of diabetes mellitus drug therapy). RESULTS: During 2000 and 2001, 79.4% of women received a lipid test compared with 84.2% of men (chi2 = 6.69, P = .01). Also, 33.2% of women received a lipid-modifying drug compared with 45.5% of men (chi2 = 27.31, P < .01). Logistic regression analysis revealed that men were more likely than women to receive a lipid test when controlling for age, cardiovascular disease diagnosis, and illness severity (odds ratio [OR], 1.45; 95% confidence interval, 1.13-1.81). Men were also more likely than women to receive a lipid-modifying drug when controlling for age, cardiovascular disease diagnosis, illness severity, and lipid testing (OR, 1.51; 95% confidence interval, 1.22-1.86). CONCLUSION:Women with type 2 diabetes mellitus were less likely than men with type 2 diabetes mellitus to receive lipid tests or lipid-modifying drugs.
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