Basal Insulin Persistence, Associated Factors, and Outcomes After Treatment Initiation Among People With Type 2 Diabetes Mellitus In Japan

Abstract

A611within and between the MTM members and controls were measured (differencein-differences (DID) analysis). Results: 2382 patients (MTM group: n= 201, mean age= 75,44%male; control group: n= 2181,mean age= 74,48%male) in the diabetes cohort and 9751 patients (MTM group: n= 563, mean age= 76,39% male; control group: n= 9188, mean age= 75,40% male) in the hypertension cohort were included. For patients in diabetes cohort, the MTM group had pre-post increase in PDC by 5.19% (P= 0.05), while the control group had decrease of 2.82% (P< 0.01) (DID= 8.03%; P= 0.003). For patients in hypertension cohort, the MTM group had pre-post increase in PDC by 17.33% (P< 0.01), while the control group had increase of 9.64% (P< 0.01) (DID= 7.67%; P< 0.01). The PDC finding was confirmed with regression analyses with propensity score adjustment showing the MTM groups had a significant increase in pre-post PDC for hypertension, as compared with the control group, while controlling for baseline characteristics (P= 0.01). ConClusions: This study found that the pharmacist-managed MTM program significantly increased medication adherence in Medicare MAPD patients with hypertension, as compared with a control group.

Cost of medication adherence and persistence in type 2 diabetes mellitus: a literature review

“…Three studies defined a gap of 30 days as demonstrating nonpersistence,17,23,24 while one defined a longer gap of 90 days 13. Two studies provided a definition of “interrupters” as patients who received at least one prescription after a gap 17,24. A data-driven approach to the measurement of persistence was taken in one study, again due to the issues of using days supply encountered with injectable treatments 11…”

Initiation of Basal Insulin Analog Treatment for Type 2 Diabetes and Reasons Behind Patients’ Treatment Persistence Behavior: Real-World Data from Germany

“…Poor treatment adherence and persistence have been shown to affect the real-world effectiveness of insulin and negatively impacts desired clinical and economic outcomes [5][6][7][8][9][10][11][12][13]. While several studies have examined persistence with basal insulin treatment [8,10,[14][15][16][17][18][19][20][21], few studies have explored the patients' reasons for continuing treatment [19] or distinguished among patients who temporarily interrupted therapy versus those who discontinued insulin completely [14,18,19].…”

Factors and outcomes associated with discontinuation of basal insulin therapy in patients with type 2 diabetes mellitus

“…This may partly be attributed to poor persistence to insulin therapy, defined as the duration of time from initiation to discontinuation of treatment or the proportion of patients who continued treatment for a specific time . Previous studies also revealed discontinued basal insulin (BI) treatment incurred higher medical resource use and costs than continuers . While several studies have examined factors associated with insulin treatment persistence such as age, comorbidity, type of initiated insulin and concomitant antidiabetic drug use, few studies have explored the patients' reasons for discontinuing treatment.…”

“…While several studies have examined factors associated with insulin treatment persistence such as age, comorbidity, type of initiated insulin and concomitant antidiabetic drug use, few studies have explored the patients' reasons for discontinuing treatment. In addition, most studies assessed persistence patterns using retrospective claims rather than actual medication‐taking behaviour . The limited information hinders better management of treatment after initiating insulin to improve patients' persistence with insulin treatment.…”