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Table 4 Hazard ratios for antiglycemic intensification, and for the competing event, in the main model that examines MHC in aggregate*

From: Mental illness and intensification of diabetes medications: an observational cohort study

  0-14 days 15-30 days 31-180 days
Parameter HR 95% CI HR 95% CI HR 95% CI
MAIN ANALYSIS (Outcome: Intensification)       
MHC (1 = yes, 0 = no) 0.99 0.96-1.03 1.13 1.04-1.23 1.12 1.07-1.18
Index HbA1c value 9–9.9 1.24 1.20-1.28 1.38 1.27-1.50 1.36 1.29-1.43
Index HbA1c value 10–10.9 1.32 1.26-1.38 1.29 1.15-1.45 1.49 1.40-1.59
Index HbA1c value 11–11.9 1.47 1.39-1.56 1.68 1.46-1.94 1.65 1.51-1.81
Index HbA1c value 12.0+ 1.57 1.47-1.67 1.47 1.25-1.73 1.65 1.49-1.82
Sex (1 = male, 0 = female) 0.98 0.89-1.08 0.92 0.73-1.17 0.89 0.77-1.02
Log physical comorbidity index 1.01 0.98-1.04 1.03 0.95-1.11 1.24 1.18-1.30
Age (per 10 years) 0.95 0.94–0.97 0.95 0.92-0.99 0.93 0.91-0.95
Any macrovascular comorbidity 1.01 0.98-1.04 1.04 0.96-1.12 1.03 0.98-1.08
Any microvascular comorbidity 0.95 0.91-0.99 0.95 0.86-1.05 1.15 1.08-1.22
COMPETING EVENT (CE) ANALYSIS (Outcome: HbA1c value <8.0)       
MHC (CE) (1 = yes, 0 = no)      1.16 1.08-1.25
Index HbA1c value 9–9.9 (CE)      0.56 0.51-0.60
Index HbA1c value 10–10.9 (CE)      0.31 0.27-0.36
Index HbA1c value 11–11.9 (CE)      0.28 0.22-0.35
Index HbA1c value 12.0+ (CE)      0.24 0.18-0.32
Sex (CE) (1 = male, 0 = female)      1.08 0.86-1.35
Log physical comorbidity index (CE)      1.29 1.21-1.37
Age (per 10 years) (CE)      0.99 0.96-1.02
Any macrovascular comorbidity (CE)      0.95 0.89-1.01
Any microvascular comorbidity (CE)      1.10 1.02-1.20
  1. Legend: This table shows Hazard Ratios for intensification of antiglycemic medications in the 0–14, 15–30 and 31–180 days following HbA1c value ≥8.0, and for the competing event (HbA1c value <8.0) in the 31–180 days following HbA1c value ≥8.0.
  2. *Hazard Ratios (HR) with statistically significant p-values (at p < .05) are shown in bold type face. Here “hazard rate” is the instantaneous rate of an event among those who have not experienced an event. The ratio of these rates under two different conditions is the “hazard ratio” (e.g., with MHC versus without MHC).
  3. In the 0–14 day and 15–30 day models, hospitalization, death, subsequent HbA1c value <8.0 and end of the specific interval without an event are treated as censoring variables. In the 31–180 day model, hospitalization, death and end of the interval without an event are treated as censoring variables, and subsequent HbA1c value <8.0 is treated as a competing event (with Hazard Ratios for the competing event shown in the lower half of the table). All analyses also control for the 125 VA facilities, through 124 individual dummy variables; the hazard ratios for each of those facilities are not shown in this table, for parsimony. The overall P-value for the facilities effect is <0.001 in each of the three time intervals.
  4. Reference group for Index HbA1c value is HbA1c value of 8–8.9.
  5. Abbreviations: MHC, Mental Health Condition; HbA1c, Hemoglobin A1c; HR, Hazard Ratio; CI, Confidence Interval; CE, Competing Event analysis.