Predictors of medication nonadherence among patients with diabetes in Medicare Part D programs: A retrospective cohort study

Yang, Yi; Thumula, Vennela; Pace, Patrick F.; Banahan, Benjamin F.; Wilkin, Noel E.; Lobb, William B.

doi:10.1016/j.clinthera.2009.10.002

Cited by 130 publications

(134 citation statements)

References 41 publications

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“…The study included a wash-in period to assess patient treatment history and a lengthy period during which treatment noncompliance could be assessed. The observed findings with respect to patient age, BMI, HbA 1c , and current smoking across the compliance categories are also consistent with previous reports (18)(19)(20). Finally, the study was able to assess the ultimate patient-relevant outcome: mortality.…”

Section: Mortalitysupporting

confidence: 92%

The impact of treatment non-compliance on mortality in people with type 1 diabetes

Currie

Peyrot

Morgan³

et al. 2013

Journal of Diabetes and its Complications

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OBJECTIVEdTo assess the association of compliance with treatment (medication and clinic appointments) and all-cause mortality in people with insulin-treated type 2 diabetes.RESEARCH DESIGN AND METHODSdData were extracted from U.K. general practice records and included patients (N = 15,984) who had diagnostic codes indicative of type 2 diabetes or who had received a prescription for an oral antidiabetic agent and were treated with insulin. Records in the 30 months before the index date were inspected for clinical codes (recorded at consultation) indicating medication noncompliance or medical appointment nonattendance. Noncompliance was defined as missing more than one scheduled visit or having at least one provider code for not taking medications as prescribed. Relative survival postindex date was compared by determining progression to all-cause mortality using Cox proportional hazards models.RESULTSdThose identified as clinic nonattenders were more likely to be smokers, younger, have higher HbA 1c , and have more prior primary care contacts and greater morbidity (P , 0.001). Those identified as medication noncompliers were more likely to be women (P = 0.001), smokers (P = 0.014), and have higher HbA 1c , more prior primary care contacts, and greater morbidity (all P , 0.001). After adjustment for confounding factors, medication noncompliance (hazard ratio 1.579 [95% CI 1.167-2.135]), clinic nonattendance of one or two missed appointments (1.163 [1.042-1.299]), and clinic nonattendance of greater than two missed appointments (1.605 [1.356-1.900]) were independent risk factors for all-cause mortality.CONCLUSIONSdMedication noncompliance and clinic nonattendance, assessed during routine care by primary care physicians or their staff, were independently associated with increased all-cause mortality in patients with type 2 diabetes receiving insulin.

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Section: Mortalitysupporting

confidence: 92%

The impact of treatment non-compliance on mortality in people with type 1 diabetes

Currie

Peyrot

Morgan³

et al. 2013

Journal of Diabetes and its Complications

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“…Age, marital status, diet found in the locality or surrounding environment, diet accessible by distance, diet accessible from the workplace, occupation status emerged as key spotlight factors in adherence model. These study results, did not fully agree with other studies that have concluded that socio-economic factors are weak in predicting adherence [13,39,41]. Although in this study sex did not have an influence on adherence, other studies have indicated that women are twice more likely to be depressed [22] leading to a dissatisfaction with care and subsequently, poor adherence to diabetes self-care [8].…”

Section: Discussioncontrasting

confidence: 55%

Key Factors on the Spotlight as Predictors of Dietary Adherence Among Patients Living with Type 2 Diabetes

Musee¹,

Okeyo²,

Odiwuor³

2016

EJPM

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Abstract:There is a rise in prevalence of Type 2 diabetes in Kenya, and an increase in related complications, which lead to disability and death. Diet modification oriented for this group of patients includes recommendations to control blood sugar, lipid levels and pressure which are vital in lowering risk and complications development in the management of Type 2 diabetes. Studies indicate that adherence to diet therapy is weak in the midst of diet recommendations and patients' education. There seems to be limited literature in developing countries as to the most critical factors in the prediction mix of adherence. This article attempts to display the competitiveness between socio-demographic and patient education related factors in the context of adherence. Across sectional analysis of a sample of 240 eligible diabetics was used and their dietary behaviour evaluated using a pre-tested dietary habit assessment survey tool with socio-demographic and patient-focus education factors. Linear regression preceded by principle axis factoring to categories adherences was executed. The results indicated that diet characterized by control of lipid levels was influenced by diet accessible within distance from home (β=0.211, t=2.053, ρ=0.041), while diet to control blood sugar and pressure was influenced by diet accessible from the workplace (β=0.193, t=2.027, ρ=0.044), occupation status (β=0.162, t=2.051, ρ=0.042), age (β=0.178, t=2.238, ρ=0.026), marital status (β=0.208, t=2.731, ρ=0.007) and diet found in the locality or surrounding environment (β=0.277, t=3.034, ρ=0.003). In conclusion, adherence enhancement seems to draw reference to education sessions focused on challenges faced by the unmarried, age specifics, occupation, setting specifics.

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“…10 In addition, we included variables possibly associated with adherence including comorbidity, age, gender, visits to the general practitioner, socioeconomic status, psychosocial variables, as well as the year of cohort entry. [18][19][20][21][22][23][24] Appendix- Table 2 (available online) shows a detailed description of all variables. Since previous adherence has been identified as a dominant predictor of future adherence in COPD, 25 we did a fifth sensitivity analysis that did not include previous adherence among possible explanatory variables in the models in order to investigate possible masking of other variables caused by collinearity.…”

Section: Variables Associated With Adherencementioning

confidence: 99%

Low Use and Adherence to Maintenance Medication in Chronic Obstructive Pulmonary Disease in the General Population

et al. 2014

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OBJECTIVE:We tested the hypothesis that use of and adherence to maintenance medication is low among individuals in the general population who have chronic obstructive pulmonary disease (COPD) , even in cases of severe and very severe COPD. DESIGN AND PARTICIPANTS: We identified 5,812 individuals with COPD from the Copenhagen General Population Study, and classified them according to the Global Initiative for Obstructive Lung Disease (GOLD) airflow limitation grades 1-4. Dispensing of fixed-dose combinations of inhaled corticosteroids with long-acting beta 2 -agonists, long-acting anti-cholinergics, or long-acting beta 2 -agonists was identified in a nationwide registry. Use of medication was defined as medication dispensed during a one-year period , and adherence was calculated from dosages available in one year. KEY RESULTS: Use of fixed-dose combinations of inhaled corticosteroids with long-acting beta 2 -agonists varied from 2 % to 61 % (p<0.001, test for trend), long-acting anti-cholinergics varied from 0.4 % to 36 % (p<0.001), and long-acting beta 2 -agonists varied from 0.3 % to 11 % (p<0.001. Among utilizers of these medications, adherence varied from 29 % to 56 % (p<0.001, test for trend) across GOLD 1-4 for fixed-dose combinations of inhaled corticosteroids with long-acting beta 2 -agonists, from 51 % to 68 % (p=0.11) for long-acting anti-cholinergics, and from 25 to 62 % (p=0.01) for long-acting beta 2 -agonists. CONCLUSIONS: Use of and adherence to maintenance medication for COPD in the general population was associated with the severity of COPD as defined by GOLD, but even in severe and very severe COPD, use and adherence was low.

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Predictors of medication nonadherence among patients with diabetes in Medicare Part D programs: A retrospective cohort study

Cited by 130 publications

References 41 publications

The impact of treatment non-compliance on mortality in people with type 1 diabetes

The impact of treatment non-compliance on mortality in people with type 1 diabetes

Key Factors on the Spotlight as Predictors of Dietary Adherence Among Patients Living with Type 2 Diabetes

Low Use and Adherence to Maintenance Medication in Chronic Obstructive Pulmonary Disease in the General Population

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