{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T09:59:06Z","timestamp":1773482346568,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,6,14]],"date-time":"2016-06-14T00:00:00Z","timestamp":1465862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"AstraZeneca Pharmaceuticals"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2016,9]]},"abstract":"\n Aims<\/jats:title>\n \n To identify the time to and patient characteristics associated with treatment intensification in patients with type 2 diabetes (\n T2D<\/jats:styled-content>\n ) and poor glycaemic control.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Using a large\n US<\/jats:styled-content>\n insurance claims database, we conducted a retrospective cohort study among adult patients with\n T2D<\/jats:styled-content>\n and glycated haemoglobin (\n HbA1c<\/jats:styled-content>\n ) \u22658% (index date) after \u22653\u2009months of therapy including metformin. Patients were required to have continuous enrolment for at least 12\u2009months before (baseline) and after index date, and no injectable antidiabetes medications. We defined treatment intensification as prescription fill for injectable or additional oral antidiabetic drugs (\n OADs<\/jats:styled-content>\n ). Cox modelling was performed to identify factors associated with time to treatment intensification.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n For the 11 525 patients meeting the inclusion criteria, the mean age at index date was 57\u2009years, 40% were female and the mean index\n HbA1c<\/jats:styled-content>\n was 9.1%. Overall, 37% of patients had their treatment intensified <6\u2009months after, 11% had their treatment intensified 6\u201312\u2009months after, and 52% did not have their treatment intensified <12\u2009months after the index date. A higher index\n HbA1c<\/jats:styled-content>\n was associated with early intensification [hazard ratio (\n HR<\/jats:styled-content>\n ) 1.18 for\n HbA1c<\/jats:styled-content>\n \u22659 to <10% and\n HR<\/jats:styled-content>\n 1.41 for\n HbA1c<\/jats:styled-content>\n \u226510% compared with\n HbA1c<\/jats:styled-content>\n \u22658 to <9%; p\u2009<\u20090.0001), and later line of therapy was associated with late intensification (\n HR<\/jats:styled-content>\n 0.78 for metformin with one\n OAD<\/jats:styled-content>\n and\n HR<\/jats:styled-content>\n 0.68 for metformin with \u22652\n OADs<\/jats:styled-content>\n compared with metformin monotherapy; p\u2009<\u20090.0001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Fewer than half of patients with\n T2D<\/jats:styled-content>\n and treatment failure received intensification within 12\u2009months in a real\u2010world\n US<\/jats:styled-content>\n population. Factors associated with treatment inertia can be used to target clinical care for these patients.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.12683","type":"journal-article","created":{"date-parts":[[2016,5,10]],"date-time":"2016-05-10T05:55:49Z","timestamp":1462859749000},"page":"892-898","source":"Crossref","is-referenced-by-count":48,"title":["Treatment intensification for patients with type 2 diabetes and poor glycaemic control"],"prefix":"10.1111","volume":"18","author":[{"given":"A. Z.","family":"Fu","sequence":"first","affiliation":[{"name":"Georgetown University Medical Center Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. J.","family":"Sheehan","sequence":"additional","affiliation":[{"name":"AstraZeneca Pharmaceuticals, LP Fort Washington PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,6,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-2441"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP15693.CS"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.4158\/endp.19.2.a38267720403k242"},{"key":"e_1_2_6_5_1","first-page":"e288","article-title":"Changing trends in type 2 diabetes mellitus treatment intensification, 2002\u20102010","volume":"21","author":"McCoy RG","year":"2015","journal-title":"Am J Manag Care"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP15868.OR"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-015-0260-x"},{"key":"e_1_2_6_8_1","unstructured":"HansenLG ChangS.Health research data for the real world: the MarketScan databases 2011. 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