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dc.contributor.authorGuerrero-Fernández de Alba, Inmaculada
dc.contributor.authorOrlando, Valentina
dc.contributor.authorMonetti, Valeria M
dc.contributor.authorMucherino, Sara
dc.contributor.authorGimeno-Miguel, Antonio
dc.contributor.authorVaccaro, Olga
dc.contributor.authorForjaz, Maria João 
dc.contributor.authorPoblador Plou, Beatriz
dc.contributor.authorPrados-Torres, Alexandra
dc.contributor.authorRiccardi, Gabriele
dc.contributor.authorMenditto, Enrica
dc.identifier.citationFront Pharmacol. 2020 Nov 30;11:586187.es_ES
dc.description.abstractObjectives: Little is known about the specific comorbidities contributing to higher costs in patients with type-2 diabetes mellitus (T2DM), particularly in older cases. We aimed to evaluate the prevalence, type, and cost of comorbidities occurring in older T2DM patients versus older non-T2DM patients, and the factors associated with high cost (HC) T2DM patients. Methods: Retrospective cohort study using information from the Campania Region healthcare database. People aged ≥65 years who received ≥2 prescriptions for antidiabetic drugs were identified as "T2DM patients." Comorbidities among T2DM and non-T2DM groups were assessed through the RxRiskV Index (modified version). T2DM individuals were classified according to the total cost distribution as HC or "non-high cost." Two sub-cohorts of HC T2DM patients were assessed: above 90th and 80th percentile of the total cost. Age- and sex-adjusted logistic regression models were created. Results: Among the T2DM cohort, concordant and discordant comorbidities occurred significantly more frequently than in the non-T2DM cohort. Total mean annual cost per T2DM patient due to comorbidities was €7,627 versus €4,401 per non-T2DM patient. Among T2DM patients identified as being above 90th and 80th percentiles of cost distribution, the total annual costs were >€19,577 and >€2,563, respectively. The hospitalization cost was higher for T2DM cases. Strongest predictors of being a HC T2DM patient were having ≥5 comorbidities and renal impairment. Conclusion: HC patients accrued >80% of the total comorbidities cost in older T2DM patients. Integrated care models, with holistic and patient-tailored foci, could achieve more effective T2DM care.es_ES
dc.publisherFrontiers Mediaes_ES
dc.relation.isversionofPublisher's versiones_ES
dc.subjectdrug utilizationes_ES
dc.subjectdiabetes costes_ES
dc.subjectreal-world dataes_ES
dc.subjecttype-2 diabetes mellituses_ES
dc.titleComorbidity in an Older Population with Type-2 Diabetes Mellitus: Identification of the Characteristics and Healthcare Utilization of High-Cost Patients.es_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.identifier.journalFrontiers in pharmacologyes_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemologíaes_ES

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