One-year adherence to oral antihyperglycemic medication and risk prediction of patient outcomes for adults with diabetes mellitus

Huber, Carola A; Rapold, Roland; Brüngger, Beat; Reich, Oliver; Rosemann, Thomas

doi:10.1097/md.0000000000003994

Cited by 36 publications

(59 citation statements)

References 16 publications

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“…The following of recommended self‐care activities, such as adhering to prescribed medication regimens, can reduce the odds of serious events or complications; however, the degree to which people perceive their susceptibility to diabetes‐related complications and detrimental events may affect the adoption and maintenance of these strategies . Similarly to earlier diabetes studies, the present study shows that people who are non‐adherent to antidiabetes therapy are at increased risk of myocardial infarction, ischaemic stroke and death . Importantly, findings advance our understanding of the impact of non‐adherence by suggesting that people with diabetes are susceptible to such outcomes within the first 5 years of initiating antidiabetes therapy.…”

Section: Discussionsupporting

confidence: 68%

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

et al. 2018

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Section: Discussionsupporting

confidence: 68%

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

et al. 2018

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“…30 The prevalence rate of medication non-adherence (PDC <80%) among the newly diagnosed diabetes patients was 35%, which was higher than that reported by Ho et al (21.3%) 27 but lower than that reported by Boye et al (36.9%) 28 and Huber et al (57.6%). 29 We found that there were ethnic differences in medication adherence. Indian was more likely to be medication non-adherent compared with Chinese, Malay, and others in Singapore.…”

Section: Discussionmentioning

confidence: 75%

“…27 Huber et al showed that the PDC of antihyperglycemic medication was associated with a 7% decrease in the risk of hospitalization. 29 Boye et al also provided evidence that the probability of a hospitalization and emergency room visit decreased monotonically as PDC increased. 28 Hong and Kang found that among newly diagnosed type 2 diabetes patients, patients with MPR <80% had a 1.26 times risk in hospitalization compared with patients with MPR ≥80%.…”

Section: Discussionmentioning

confidence: 97%

“…Medication adherence for diabetes patients has been reported in various studies. [27][28][29] We extracted dispensed medication records from our disease registry and calculated PDC as a measure of adherence since it is the preferred method of measuring medication adherence. 30 The prevalence rate of medication non-adherence (PDC <80%) among the newly diagnosed diabetes patients was 35%, which was higher than that reported by Ho et al (21.3%) 27 but lower than that reported by Boye et al (36.9%) 28 and Huber et al (57.6%).…”

Section: Discussionmentioning

confidence: 99%

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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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“…Approximately 75% of that gap is attributed to poor adherence . Additionally a decrease in adherence may worsen long‐term health outcomes and consequently increase associated healthcare costs . A study conducted by Alatorre et al showed that patients initiating treatment with dulaglutide had higher adherence and persistence compared with patients initiating treatment with liraglutide or exenatide once weekly at 6‐month follow‐up.…”

Section: Introductionmentioning

confidence: 99%

Adherence, persistence, glycaemic control and costs among patients with type 2 diabetes initiating dulaglutide compared with liraglutide or exenatide once weekly at 12‐month follow‐up in a real‐world setting in the United States

Mody

Huang

et al. 2019

Diabetes Obesity Metabolism

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Aims To evaluate adherence, persistence, glycaemic control and costs at 12‐month follow‐up for patients initiating dulaglutide versus liraglutide or exenatide once weekly. Materials and methods The present retrospective observational claims study included patients with type 2 diabetes (T2D) and ≥ 1 pharmacy claim for dulaglutide, liraglutide or exenatide once weekly from the HealthCore Integrated Research Database. Adherence was defined as proportion of days covered ≥80%, and persistence was measured by time to discontinuation of index therapy. Change from baseline in glycated haemoglobin (HbA1c) concentration was assessed in a subset with pre‐ and post‐index HbA1c results. Propensity scores were used to match the cohorts. Results The baseline characteristics were balanced for the matched cohorts, dulaglutide versus liraglutide (n = 2471) and dulaglutide versus exenatide once weekly (n = 1891). Among those initiating dulaglutide there was a significantly higher proportion of adherent patients compared with the groups initiating liraglutide (51.2% vs. 38.2%; P < 0.001) and exenatide once weekly (50.7% vs. 31.9%; P < 0.001). At 12 months, 55% of patients in the dulaglutide group versus 43.8% in the liraglutide group (P < 0.001), and 54.9% in the dulaglutide versus 34.4% in the exenatide once‐weekly group (P < 0.001) were persistent. The dulaglutide group had a significantly greater reduction in HbA1c than the liraglutide group (−34.24 vs. −31.94 mmol/mol; P = 0.032), and a greater, but nonsignificant, reduction in HbA1c than the exenatide once‐weekly group (−34.46 vs. −31.94 mmol/mol; P = 0.056). The diabetes‐related total costs were not significantly different between the dulaglutide and the liraglutide group ($16,174 vs. $16,694; P = 0.184), and were significantly higher for dulaglutide than for exenatide once weekly ($15,768 vs. $14,615; P = 0.005). Conclusions Adherence and persistence are important considerations in patient‐centric treatment selection for patients with T2D. Higher adherence and persistence for dulaglutide compared with liraglutide or exenatide once weekly are relevant criteria when choosing glucagon‐like peptide‐1 receptor agonist treatment for patients with T2D.

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One-year adherence to oral antihyperglycemic medication and risk prediction of patient outcomes for adults with diabetes mellitus

Abstract: Supplemental Digital Content is available in the text

Cited by 36 publications

References 16 publications

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

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

Medication adherence and glycemic control among newly diagnosed diabetes patients

Adherence, persistence, glycaemic control and costs among patients with type 2 diabetes initiating dulaglutide compared with liraglutide or exenatide once weekly at 12‐month follow‐up in a real‐world setting in the United States

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