Abstract
Background
Previous studies have shown that only a small number of pediatric and young adult
patients discontinue pump therapy, but risk factors for discontinuation are unclear.
Objective
To identify characteristics of pediatric and young adult patients with pump therapy
which are associated with discontinuation of treatment.
Subjects and methods
Retrospective cohort study using a representative nationwide database (LRx; IMS Health)
in Germany covering >80% of all prescriptions to members of statutory health insurances
in 2008–2011. All patients (age group <25 years) with new prescriptions of insulin
pumps were identified (2009–2010) and were followed for 12 months.
Results
Overall, 2452 new pump users were identified, of whom 177 (7.2%) switched to other
forms of insulin therapy within 12 months. In multivariate logistic regression, younger
age (<6 years; reference 18 to <25 years: Odds ratio, OR, 95% CI: 0.36; 0.17–0.74)
and use of teflon needles (reference steel needles: OR, 95% CI: 0.59; 0.41–0.83) were
related to a lower odds of pump discontinuation. A non-significant trend was found
for male sex (OR, 95% CI: 0.75; 0.52–1.08). Prescriptions of thyroid therapeutics
(ATC H03A: OR, 95% CI: 1.79; 1.23–2.61) and antiepileptics (N03: OR, 95% CI: 3.14;
1.49–6.59) were significantly associated with discontinuation of pump therapy.
Conclusions
About 93% of pediatric and young adult patients maintained insulin pump therapy within
12 months. Age <6 years, male sex and teflon needle use were associated with a lower
risk of discontinuation. Thyroid therapy (indicating autoimmunity) and antiepileptic
drug prescriptions were associated with a higher likelihood for discontinuation of
insulin pump treatment.
Keywords
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Article info
Publication history
Published online: April 15, 2014
Accepted:
March 19,
2014
Received in revised form:
March 13,
2014
Received:
September 18,
2013
Identification
Copyright
© 2014 Primary Care Diabetes Europe. Published by Elsevier Inc. All rights reserved.
