Diabetes care among elderly medicare beneficiaries with Parkinson's disease and diabetes

Persistent Link:
http://hdl.handle.net/10150/610316
Title:
Diabetes care among elderly medicare beneficiaries with Parkinson's disease and diabetes
Author:
Bhattacharjee, Sandipan; Sambamoorthi, Usha
Affiliation:
Department of Pharmacy Practice and Science, School of Pharmacy, The University of Arizona; Department of Pharmaceutical Systems & Policy, School of Pharmacy, West Virginia University
Issue Date:
2015
Publisher:
BioMed Central
Citation:
Bhattacharjee and Sambamoorthi Journal of Diabetes & Metabolic Disorders (2015) 14:75 DOI 10.1186/s40200-015-0209-3
Journal:
Journal of Diabetes & Metabolic Disorders
Rights:
© 2015 Bhattacharjee and Sambamoorthi. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
BACKGROUND: Elderly individuals with type 2 diabetes mellitus (T2DM) suffer from several comorbidities, which affect their health outcomes, as well as process of care. This study assessed process and intermediate clinical outcomes of diabetes care among elderly individuals with T2DM and co-occurring Parkinson's disease(PD). METHODS: This study used a retrospective cohort design with propensity score matching using Humana Medicare Advantage Part D claims database (2007-2011) and included elderly (age ≥ 65 years) Medicare beneficiaries with T2DM (identified by ICD-9-CM code of 250.x0 or 250.x2). PD was identified using ICD-9-CM code of 332.xx. After propensity score matching there were 2,703 individuals with T2DM and PD and 8,109 with T2DM and no PD. The three processes of care measures used in this study included: (i) HbA1c test; (ii) Lipid test; (iii) and Nephropathy screening. Intermediate clinical outcomes consisted of glycemic and lipid control. RESULTS: Multivariable conditional logistic regressions revealed that elderly individuals with T2DM and PD were 12 % (AOR: 0.88, 95 %CI: 0.79-0.97) and 18 % (AOR: 0.82, 95 %CI: 0.72-0.94) less likely to meet the annual American Diabetes Association (ADA) recommended HbA1c and lipid testing goals respectively compared to individuals with T2DM and no PD. Multinomial conditional logistic regressions showed that elderly individuals with T2DM and PD were more likely to have HbA1c and lipid (HbA1c < 8 %; LDL-C <100 mg/dl; HDL-C ≥ 50 mg/dl; triglyceride <150 mg/dl; and total cholesterol <200 mg/dl) control. CONCLUSIONS: Among elderly individuals with T2DM, those with PD were less likely to achieve ADA recommended annual HbA1c and lipid testing compared to those without PD. However, PD individuals were more likely to achieve intermediate glycemic and lipid control.
EISSN:
 2251-6581
DOI:
10.1186/s40200-015-0209-3
Keywords:
Parkinson's disease; Co-occurring conditions; Standards of Care; Propensity Score
Version:
Final published version
Additional Links:
http://jdmdonline.biomedcentral.com/articles/10.1186/s40200-015-0209-3

Full metadata record

DC FieldValue Language
dc.contributor.authorBhattacharjee, Sandipanen
dc.contributor.authorSambamoorthi, Ushaen
dc.date.accessioned2016-05-20T09:04:03Z-
dc.date.available2016-05-20T09:04:03Z-
dc.date.issued2015en
dc.identifier.citationBhattacharjee and Sambamoorthi Journal of Diabetes & Metabolic Disorders (2015) 14:75 DOI 10.1186/s40200-015-0209-3en
dc.identifier.doi10.1186/s40200-015-0209-3en
dc.identifier.urihttp://hdl.handle.net/10150/610316-
dc.description.abstractBACKGROUND: Elderly individuals with type 2 diabetes mellitus (T2DM) suffer from several comorbidities, which affect their health outcomes, as well as process of care. This study assessed process and intermediate clinical outcomes of diabetes care among elderly individuals with T2DM and co-occurring Parkinson's disease(PD). METHODS: This study used a retrospective cohort design with propensity score matching using Humana Medicare Advantage Part D claims database (2007-2011) and included elderly (age ≥ 65 years) Medicare beneficiaries with T2DM (identified by ICD-9-CM code of 250.x0 or 250.x2). PD was identified using ICD-9-CM code of 332.xx. After propensity score matching there were 2,703 individuals with T2DM and PD and 8,109 with T2DM and no PD. The three processes of care measures used in this study included: (i) HbA1c test; (ii) Lipid test; (iii) and Nephropathy screening. Intermediate clinical outcomes consisted of glycemic and lipid control. RESULTS: Multivariable conditional logistic regressions revealed that elderly individuals with T2DM and PD were 12 % (AOR: 0.88, 95 %CI: 0.79-0.97) and 18 % (AOR: 0.82, 95 %CI: 0.72-0.94) less likely to meet the annual American Diabetes Association (ADA) recommended HbA1c and lipid testing goals respectively compared to individuals with T2DM and no PD. Multinomial conditional logistic regressions showed that elderly individuals with T2DM and PD were more likely to have HbA1c and lipid (HbA1c < 8 %; LDL-C <100 mg/dl; HDL-C ≥ 50 mg/dl; triglyceride <150 mg/dl; and total cholesterol <200 mg/dl) control. CONCLUSIONS: Among elderly individuals with T2DM, those with PD were less likely to achieve ADA recommended annual HbA1c and lipid testing compared to those without PD. However, PD individuals were more likely to achieve intermediate glycemic and lipid control.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://jdmdonline.biomedcentral.com/articles/10.1186/s40200-015-0209-3en
dc.rights© 2015 Bhattacharjee and Sambamoorthi. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)en
dc.subjectParkinson's diseaseen
dc.subjectCo-occurring conditionsen
dc.subjectStandards of Careen
dc.subjectPropensity Scoreen
dc.titleDiabetes care among elderly medicare beneficiaries with Parkinson's disease and diabetesen
dc.typeArticleen
dc.identifier.eissn 2251-6581en
dc.contributor.departmentDepartment of Pharmacy Practice and Science, School of Pharmacy, The University of Arizonaen
dc.contributor.departmentDepartment of Pharmaceutical Systems & Policy, School of Pharmacy, West Virginia Universityen
dc.identifier.journalJournal of Diabetes & Metabolic Disordersen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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