Differences in health outcomes associated with initial adherence to oral antidiabetes medications among veterans with uncomplicated Type 2 diabetes: a 5‐year survival analysis

Gatwood, Justin; Chisholm-Burns, Marie A.; Davis, Robert L.; Thomas, Fridtjof; Potukuchi, Praveen K.; Hung, Adriana M.; Kövesdy, Csaba P.

doi:10.1111/dme.13775

Cited by 12 publications

(32 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…telemedicine approaches, including websites and electronic records) [ 58 ]. In addition, the impact of treatment persistence and adherence on disease management must be stressed at the time of treatment initiation [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective database analysis of new OAD users found that good adherence (defined as MPR ≥ 0.8) was associated with significantly reduced risk of a new microvascular or macrovascular diabetes complication (adjusted hazard ratio 0.96; 95% CI 0.92–1.00; P = 0.05) [ 64 ]. Initial adherence appears to be important, with another retrospective cohort study observing that during the first 5 years of OAD treatment, those who were initially nonadherent to therapy were more likely to experience myocardial infarction, ischaemic stroke, or death [ 65 ].…”

Section: Impact Of Treatment Adherence On Clinical and Economic Outcomentioning

confidence: 99%

See 1 more Smart Citation

Lack of Treatment Persistence and Treatment Nonadherence as Barriers to Glycaemic Control in Patients with Type 2 Diabetes

et al. 2019

View full text Add to dashboard Cite

Treatment persistence (continuing to take medication for the prescribed period) and treatment adherence (complying with the prescription in terms of drug schedules and dosage) are both important when treating chronic diseases such as type 2 diabetes (T2D). They can be indicators of patient satisfaction with treatment. In T2D, the achievement of optimal outcomes requires both persistence with and adherence to prescribed therapy. Poor persistence with and adherence to T2D medication can have profound consequences for the patient, including non-achievement of glycaemic goals and an increased risk of long-term complications and mortality. Therefore, poor treatment persistence and adherence may also have economic consequences, including increased healthcare resource utilization and healthcare costs. Treatment persistence and adherence are affected by several factors, including the mode of administration, administration frequency/regimen complexity, and patient expectations. The aims of this review are as follows: to provide an overview of persistence with and adherence to different antidiabetes therapies for patients with T2D in the real-world setting; examine factors contributing to poor treatment persistence and adherence; and assess available data on the impact of poor treatment persistence and/or adherence on clinical and economic outcomes. Numerous potential targets for improving treatment persistence and/or adherence are identified, including developing less complex treatment regimens with lower pill burdens or less frequent injections, improving the convenience of drug-delivery systems, such as the use of insulin pen devices rather than the conventional vial and syringe, and developing therapies with an improved safety profile to alleviate patient fears of adverse effects, such as weight gain and risk of hypoglycaemia. Funding : Sanofi.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Impact Of Treatment Adherence On Clinical and Economic Outcomentioning

confidence: 99%

Lack of Treatment Persistence and Treatment Nonadherence as Barriers to Glycaemic Control in Patients with Type 2 Diabetes

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Poor glycaemic control due to non-adherence to OADs can lead to higher microvascular complications (ie, nephropathy, retinopathy, and neuropathy),67 higher macrovascular complications (ie, MI and ischaemic stroke)68 and high risk of mortality,68 hospitalisation and emergency department visits 16. Besides, poor glycaemic control due to non-adherence to OADs can lead to an increased diabetes care cost.…”

Section: Discussionmentioning

confidence: 99%

Oral antidiabetic medication adherence and glycaemic control among patients with type 2 diabetes mellitus: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia

et al. 2019

View full text Add to dashboard Cite

ObjectivesThe purpose of this study is to measure the adherence rates of oral antidiabetic drugs (OADs) in patients with type 2 diabetes mellitus (T2DM) and assess the relationship of glycaemic control and adherence to OADs after controlling for other associated factors.DesignCross-sectional retrospective study.SettingLarge tertiary hospital in the central region of Saudi Arabia.Participants5457patients aged 18 years and older diagnosed with T2DM during the period from 1 January 2016 to 31 December 2016.Primary and secondary outcome measuresThe modified medication possession ratio (mMPR) was calculated as a proxy measure for adherence of OADs. The factors associated with OADs non-adherence and medication oversupply were assessed using multinomial logistic regression models. The secondary outcomes were to measure the association between OADs adherence and glycaemic control.ResultsMajority of patients with T2DM were females (n=3400, 62.3%). The average glycated haemoglobin was 8.2±1.67. Among the study population, 48.6% had good adherence (mMPR >0.8) and 8.6% had a medication oversupply (mMPR >1.2). Good adherence was highest among those using repaglinide (71.0%) followed by pioglitazone (65.0%) and sitagliptin (59.0%). In the multivariate analysis, women with T2DM were more likely to have poor adherence (adjusted OR (AOR)=0.76, 95% CI=0.67, 0.86) compared with men. Also, medication oversupply was more likely among patients with hyperpolypharmacy (AOR=1.88, 95% CI=1.36, 2.63), comorbid osteoarthritis (AOR=1.72, 95% CI=1.20, 02.45) and non-Saudi patients (AOR=1.53, 95% CI=1.16, 2.01). However, no association was found between glycaemic control and adherence to OADs.ConclusionThe study findings support the growing concern of non-adherence to OADs among patients with T2DM in Saudi Arabia. Decision makers have to invest in behavioural interventions that will boost medication adherence rates. This is particularly important in patients with polypharmacy and high burden of comorbid conditions.

show abstract

“…Our previous analyses comparing cardiovascular, cerebrovascular, microvascular, and all-cause mortality outcomes by medication adherence status among veterans with diabetes revealed that while many outcomes were improved by higher rates of medication use, adherence did not prevent all targeted outcomes. 12 Moreover, when adjusting for patient characteristics and first-year medication adherence, differences in outcomes were observed in subgroups of this population, including minorities and those residing in different geographical regions. Such findings reinforce the importance of adherence while suggesting the need for deeper analyses focusing on potential disparities among population subgroups.…”

Section: Introductionmentioning

confidence: 88%

“…In analyses ranging from 3 to 9 years of follow-up, being adherent has been connected with a decreased likelihood of diabetes-related outcomes, such as hypoglycemia, microvascular complications, hospitalization, and cardiovascular or cerebrovascular events. [12][13][14][15][16] Despite comparatively better outcomes by having more medication on hand (i.e., higher PDC), being adherent to antidiabetic medications is not a guarantee that undesired outcomes will be avoided. Our previous analyses comparing cardiovascular, cerebrovascular, microvascular, and all-cause mortality outcomes by medication adherence status among veterans with diabetes revealed that while many outcomes were improved by higher rates of medication use, adherence did not prevent all targeted outcomes.…”

Section: Introductionmentioning

confidence: 99%

Racial and Regional Disparities in Outcomes Among Veterans Initially Adherent to Oral Antidiabetic Therapies: an Observational Cohort Study

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

Differences in health outcomes associated with initial adherence to oral antidiabetes medications among veterans with uncomplicated Type 2 diabetes: a 5‐year survival analysis

Abstract: People who are non-adherent to treatment were more likely to experience detrimental health outcomes within the first 5 years of antidiabetes therapy. Adherence is paramount to disease management and this should be stressed from the time at which treatment is initiated.

Cited by 12 publications

References 27 publications

Lack of Treatment Persistence and Treatment Nonadherence as Barriers to Glycaemic Control in Patients with Type 2 Diabetes

Lack of Treatment Persistence and Treatment Nonadherence as Barriers to Glycaemic Control in Patients with Type 2 Diabetes

Oral antidiabetic medication adherence and glycaemic control among patients with type 2 diabetes mellitus: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia

Racial and Regional Disparities in Outcomes Among Veterans Initially Adherent to Oral Antidiabetic Therapies: an Observational Cohort Study

Contact Info

Product

Resources

About