Oral antidiabetic medication adherence and glycemic control in managed care.
Am J Manag Care
; 14(2): 71-5, 2008 Feb.
Article
in En
| MEDLINE
| ID: mdl-18269302
ABSTRACT
OBJECTIVE:
To evaluate adherence to oral diabetes medications (ODMs) in patients with type 2 diabetes and the impact of ODM adherence on glycemic control. STUDYDESIGN:
Retrospective observational study.METHODS:
Medical and pharmacy claims from a managed care plan in Oregon were used to identify adults with diabetes who newly initiated ODM therapy (n = 2741); a subset of this cohort linked to electronic health records was used to evaluate the relationship between adherence and glycemic control (n = 249). Glycemic control was assessed based on most recent glycosylated hemoglobin (A1C) measurement within the study period.RESULTS:
Mean cohort age was 54 years; 46% initiated therapy with metformin, 39% with a sulfonylurea, and 12% with a thiazolidinedione. Mean adherence overall was 81%, and 65% of subjects had good adherence (>80%). Increasing age and comorbidity burden were associated with higher medication adherence. In the patient subset with A1C measurements, mean baseline A1C was 8%. An inverse relationship existed between ODM adherence and A1C; controlling for baseline A1C and therapy regimen, each 10% increase in ODM adherence was associated with a 0.1% A1C decrease (P = .0004).CONCLUSION:
Although most patients were adherent to ODM therapy, adherent patients were more likely to achieve glycemic control than nonadherent patients. Greater efforts are needed to facilitate diabetes self-management behaviors to improve patient outcomes.
Search on Google
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Compliance
/
Diabetes Mellitus, Type 2
/
Hypoglycemic Agents
Type of study:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Am J Manag Care
Journal subject:
SERVICOS DE SAUDE
Year:
2008
Document type:
Article
Affiliation country:
Estados Unidos