Medication adherence and racial differences in diabetes in the USA: an update

Adams, Alyce S.; Banerjee, Somalee; Ku, Carolyn J

doi:10.2217/dmt.14.55

Cited by 8 publications

(9 citation statements)

References 50 publications

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“…Strong evidence of racial and ethnic disparities in long-term medication adherence has been reported in a systematic review of medication adherence and racial differences in diabetes in the USA. 31 The disparities could be caused by both non-modifiable factors like financial burden of medications, competing demands, cultural and social barriers, family support; and Figure 3 Crude and adjusted ORs of hospitalization or emergency department (ED) visit by medication adherence group (proportion of days covered (PDC)) by linear regression, controlling for age, age 2 , gender, race, marital status, years in hypertension, years in dyslipidemia, and baseline Hba1c level (reference group: PDC=100%).…”

Section: Discussionmentioning

confidence: 99%

Medication adherence and glycemic control among newly diagnosed diabetes patients

Lin¹,

Sun²,

Heng³

et al. 2017

BMJ Open Diab Res Care

103

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BackgroundPoor medication adherence can have negative consequences for the patients, the provider, the physician, and the sustainability of the healthcare system. To our knowledge, the association between medication adherence and glycemic control among newly diagnosed diabetes patients has not been studied. This study aims to bridge the gap.MethodThis is a retrospective cohort study of 2463 patients managed in the National Healthcare Group in Singapore with newly diagnosed diabetes. Patients were followed up for the first two years from their first medication dispensed for measuring medication adherence, proportion of days covered (PDC); and for another three years for investigating outcomes of glycemic control, emergency department visit, and hospitalization. Multivariable regressions were performed to study the association between medication adherence and the outcomes as well as the risk factors of poor adherence.ResultsThe prevalence of medication adherence (PDC≥80%) was 65.0% (95% CI 63.1% to 66.9%) among newly diagnosed diabetes patients in Singapore. Male, Indian, or patients without hypertension or dyslipidemia were associated with poorer medication adherence. The HbA1c level of poor adherent patients (PDC <40%) increased by 0.4 (95% CI 0.2 to 0.5) over the two years, and they were also more likely to have hospitalization (OR 2.6,95% CI 1.7 to 3.8) or emergency department visit (OR 2.4,95% CI 1.7 to 3.4) compared with the fully adherent patients (PDC=100%).ConclusionsThe medication adherence in the early stage of diabetes is important for maximizing the effectiveness of pharmaceutical therapy. Health policies or interventions targeting the improvement of medication adherence among newly diagnosed diabetes patients are in need.

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Section: Discussionmentioning

confidence: 99%

Medication adherence and glycemic control among newly diagnosed diabetes patients

Lin¹,

Sun²,

Heng³

et al. 2017

BMJ Open Diab Res Care

103

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Such disparities between ethnic groups are not specific to our culture, as differences in adherence have been reported in diabetic patients in the United States. This systematic review discussed interactions between variables affecting adherence such as health literacy, medication concerns and affordability, as well as family support and cultural barriers (Adams, Banerjee, & Ku, ). Cultural factors that may promote non‐adherence in Malays include beliefs in spiritual causes for mental illness (Khan et al, ; Kua, Wong, Kua, & Tsoi, ; Ng, ), as well as sociodemographic differences as observed in our study.…”

Section: Discussionmentioning

confidence: 99%

Medication adherence in first‐episode psychosis patients in Singapore

Tan

Abdin

Liang

et al. 2018

Early Intervention Psych

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“…8,9 The drivers of non-adherence among blacks with diabetes are multifactorial and include reduced health literacy, medication misbeliefs, concerns about medication side effects, and medication costs issues. [10][11][12][13] Results from a few small randomized clinical trials suggest that primary care-based pharmacist-led management, a delivery system design intervention that uses clinical pharmacists to address care quality and patient self-management behavior, may be an effective strategy for improving cardiovascular risk factor control among black individuals with diabetes. Rothman et al found that minorities with Hba1c ≥ 8, randomized to an intervention in which a clinical pharmacist provided patient education, addressed barriers to care, and managed cardiovascular risk factors using algorithms, during monthly visits, had reductions in HbA1c and systolic blood pressure (SBP) of 0.8% and 9 mmHg, respectively, after 12 months.…”

Section: Introductionmentioning

confidence: 99%