Difficulty adhering to antidiabetic treatment: Factors associated with persistence and compliance

• Published in: Diabetes & metabolism 2013-05, Vol.39 (3), p.250-257
• Main Authors: Guénette, L, Moisan, J, Breton, M.-C, Sirois, C, Grégoire, J.-P
• Format: Article
• Language: English
• Subjects: Adherence; Adhésion; Adolescent; Adult; Aged; Aged, 80 and over; Antidiabétiques oraux; Biological and medical sciences; Cohort Studies; Compliance; Determinants; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - psychology; Diabetes. Impaired glucose tolerance; Diabète de type 2; Déterminants; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Hypoglycemic Agents - administration & dosage; Internal Medicine; Male; Medical sciences; Medication Adherence - statistics & numerical data; Middle Aged; Observance; Oral antidiabetic treatment; Persistance; Persistence; Quebec - epidemiology; Type 2 diabetes
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2012.12.005

Abstract Aims This study aimed to assess the 1-year treatment persistence and compliance of new oral antidiabetic drug (OAD) users with their treatment, and to identify the factors associated with both persistence and compliance. Methods This population-based cohort study of new OAD users aged 18 years or above used the Quebec health insurance board databases. Those having a prescription filled for antidiabetic treatment during the period leading up to the 1-year anniversary of their first claim were considered to be persistent with their antidiabetic treatment. Of these patients, individuals with a medication possession ratio (MPR) greater or equal to 80% for OAD or insulin were deemed compliant. Also identified were the characteristics associated with both outcomes, using a multivariate logistic regression model. Results Our cohort consisted of 151,173 individuals, 119,832 (79.3%) of whom were considered persistent. Of these, 93,418 (78.0%) were also deemed compliant. Persistence and compliance were associated with older ages, living in a rural region, low socioeconomic status, having the first OAD prescribed by a general practitioner and a history of using five different drugs or more. People were less likely to be persistent and compliant if their initial OAD was a secretagogue and if they had consulted a physician eight times or more during the year prior to starting treatment. Conclusion One year after OAD treatment initiation, 21% had discontinued their treatment and 22% of those still being treated were non-compliant. These results could help to tailor interventions aimed at optimizing the use of OAD treatments.