We aimed to evaluate the experience of patients with type 2 diabetes (T2DM) with healthcare received in Spain. This was a retrospective, observational study in patients with T2DM cared for in primary healthcare (PHC) centers. A cross-sectional analysis of the patients’ experience data was performed using the Instrument for the Evaluation of the Experience of Chronic Patients (IEXPAC). A total of 475 patients with T2DM were recruited from 36 PHC centers, of which 248 (52.2%) completed the IEXPAC questionnaire. The IEXPAC total mean score (range 0–10) was 7 points, with an average “new relational model” score of 2.5 points. The mean continuity of care score after hospital discharge was 6.2 points. The results showed that 8% of the patients always or almost always used the internet to check their medical history, appointments or other data from their healthcare service, and 15% responded that healthcare professionals always or almost always informed them of forums or other reliable internet sites to obtain information about their illness. The study results show that there is a wide margin for improvement in the experience of patients with T2DM with healthcare in Spain, especially regarding the information patients receive or can obtain.

Introduction Studies on treatment adherence to glucose‐lowering drugs among patients with type 2 diabetes (T2D) including concomitant treatment for other cardiovascular risk factors are scarce. We aimed to estimate the prevalence of good adherence to all medications used to control diabetes, hypertension and dyslipidemia and to analyse cardiometabolic control and its associated factors in T2D patients in the primary care (PC) setting. Methods Observational, retrospective study conducted in adult patients with T2D who were followed in the PC setting in Spain. Patients were classified as adherent in a particular category if the summary of the proportion of days covered (PDC) for a particular medication category was ≥80% and were considered globally adherent if the PDC was ≥80% for each of the 3 medication categories. Results A total of 457 evaluable patients were recruited, among which 321 patients (70.3%, 95% CI 65.8 to 74.4) were adherent to the three drug categories. The proportion of patients controlled for the 3 cardiometabolic risk factors was 31% according to the contemporary clinical practice guideline criteria, 58% according to investigator judgment and 36% when the objective for HbA1c was individualized. In a multivariate analysis, presenting comorbidities was associated with a lower likelihood of showing adequate control of dyslipidemia (odds ratio [OR] 0.25, 95% CI, 0.16–0.40) and the three cardiometabolic factors as a whole (OR 0.43, 95% CI 0.26–0.70). In a post hoc analysis, therapeutic inertia was found to be greater for dyslipidemia and hypertension than for T2D. Conclusions Despite a relatively high adherence to all medications for treating diabetes, hypertension and dyslipidemia in patients with T2D in the PC setting in Spain, the control of cardiometabolic risk factors as a whole is far from optimal. This could be related, at least in part, to the high frequency of comorbidity of these patients.

Aim To assess the experience with health care among patients with type 2 diabetes (T2DM) and to evaluate patients’ demographic variables and healthcare‐related characteristics which may affect their experience. Methods A cross‐sectional survey was delivered to T2DM adults. Patient experiences were assessed with the ‘Instrument for Evaluation of the Experience of Chronic Patients’ (IEXPAC) questionnaire, a validated 12‐item survey, which describes patient experience within the last 6 months (items 1–11) and hospitalization in the last 3 years (item 12), with possible scores ranging from 0 (worst) to 10 (best experience). Results A total of 451 T2DM patients responded to the survey (response rate 72.3%; mean age 69.5 ± 10.1 years, 67.8% men). The mean overall IEXPAC score was 5.92 ± 1.80. Mean scores were higher for productive interactions (7.92 ± 2.15) and self‐management (7.08 ± 2.27) than for new relational model (1.72 ± 2.01). Only 32.8% of patients who had been hospitalized in the past 3 years reported having received a follow‐up call or visit after discharge. Multivariate analyses identified that regular follow‐up by the same physician and follow‐up by a nurse were associated with a better patient experience. Continuity of healthcare score was higher only in those patients requiring help from others. Conclusions The areas of T2DM care which may need to be addressed to ensure better patient experience are use of the Internet, new technologies and social resources for patient information and interaction with healthcare professionals, closer follow‐up after hospitalization, and a comprehensive multidisciplinary approach with regular follow‐up by the same physician and a nurse.

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Objective: To estimate the CKD (GFR <60 ml/min and/or UACR ≥ 30 mg/g) prevalence among T2DM patients and evaluate the use of antidiabetic drugs based on renal function. Methods: Retrospective, cross-sectional study, analyzing data from the Spanish electronic records database “Information System for the Development of Research in Primary Care, SIDIAP”, from Jan, 2015 to Dec, 2016. The use of antidiabetic drugs for each stage of chronic renal failure (CRF; GFR<60 mL/min) was evaluated in patients with available records of GFR. Furthermore, the adjusted RR for 5 events (global mortality, cardiovascular mortality, renal failure treated with dialysis or transplantation, acute renal failure and progression of kidney disease) according to KDIGO 2012 guidelines were assessed in those patients with available registers of both UACR and GFR. Results: From the overall T2DM study population (373,185), 33% (122,296) had CKD, of those, 48% were women, with a mean age of 76 years, a mean T2DM duration of 11 years and a mean HbA1c value of 7.2% (SD 1.37). A total of 336,198 patients (90%) had GFR data, and 94,240 (28%) had CRF. Among those with GFR 30 to < 45 mL/min (29,038; 8.9%), metformin was the most frequently used drug (49.6%), followed by insulin (33.5%), DPP-4i (21%) and sulfonylureas (15.9%). Among patients with GFR < 30 mL/min (13,262, 4%), insulin was the most used drug (50%), followed by DPP-4i (23%), metformin (16%), repaglinide (16%) and sulfonylureas (6.1%). The KDIGO 5 event-adjusted RR distribution among the 236,830 patients with available values of both UACR and GFR was: Low: 60.9%; Mild: 21.6%, High: 9.8% and Very high: 7.7%. Conclusion: CKD is a very frequent comorbidity among T2DM patients. The use of antidiabetic drugs is more complex in these patients because many people with kidney disease are often elderly, and have long lasting disease and significant comorbidities. A relevant number of T2DM patients are still treated with contraindicated antidiabetic drugs regarding their renal function. Disclosure M. Mata-Cases: None. J. Franch-Nadal: None. J. Real: None. K. Ferreira de Campos: Employee; Self; Merck Sharp & Dohme Corp. M. Cedenilla: Employee; Self; Merck Sharp & Dohme Corp. A. Gómez: Employee; Self; Merck Sharp & Dohme Corp. D. Mauricio: Advisory Panel; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; Eli Lilly and Company, GlaxoSmithKline plc.. Research Support; Self; GlaxoSmithKline plc.. Advisory Panel; Self; Janssen-Cilag Pty Limited. Speaker's Bureau; Self; Merck Sharp & Dohme Corp.. Board Member; Self; Merck Sharp & Dohme Corp.. Research Support; Self; Merck Sharp & Dohme Corp.. Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S. Advisory Panel; Self; Sanofi. Board Member; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; Sanofi.