Comparison of persistence and adherence between DPP-4 inhibitor administration frequencies in patients with type 2 diabetes mellitus in Japan: a claims-based cohort study

Abstract

Objective: To explore persistence and adherence with once-daily, twice-daily, or once-weekly DPP-4 inhibitors (DPP-4i) in Japanese patients with type 2 diabetes. Methods: This retrospective, longitudinal, observational cohort study used data from the Japanese nationwide hospital-based Medical Data Vision (MDV) administrative claims database. Data were collected for patients given a new DPP-4i prescription between May 2015 and June 2017 with 1-year follow-up until May 2018. Treatment persistence was defined as the total duration of continuous prescription. Adherence to treatment was measured as the proportion of days covered (PDC). Results: A total of 598,419 patients with a prescription for DPP-4i treatment were identified in the MDV database. Of the 39,826 patients who met the inclusion criteria, 82.4% were receiving once-daily DPP-4i, 15.6% twice-daily DPP-4i, and 2.0% once-weekly DPP-4i. Twelve-month persistence rates with once-daily regimens were 66.3% versus 64.7% with twice-daily (p ¼ .1187), and versus 38.8% with once-weekly, regimens (p < .0001) in the overall population (including untreated [UT] and previously treated [PT] patients); 62.8% with once-daily versus 58.3% with twice-daily (p ¼ .0309), and versus 12.3% with once-weekly regimens (p < .0001) in the UT cohort; and 68.6% with once-daily versus 67.9% with twice-daily (p ¼ .5471), and versus 49.1% with once-weekly regimens (p < .0001) in the PT cohort. In the overall population, 97.8% of patients had a mean PDC of 0.97 with once-and twicedaily, and 65.8% of patients had a mean PDC of 0.74 with once-weekly, DPP-4i regimens. Conclusions: Overall, persistence at 12 months was highest in patients receiving once-daily DPP-4i regimens.

Medication adherence, recall periods and factors affecting it: A community‐based assessment on patients with chronic diseases in urban slums

“…In clinical practice, where quick, efficient and low‐cost approaches to evaluate adherence is desired, this could help the physicians to rely confidently on either one week or one month self‐reported adherence in making prescribing decisions while having to ask lesser number of questions. Although several studies have reported how daily, weekly and monthly drug regimens could help in determining the adherence rate, 18,19 we could not find much‐published literature on similar correlations for adherence based on different time‐periods. A study on 78 patients receiving antiretroviral treatment showed that reported adherence is more accurate for longer recall periods as compared with one, two and three days 22 .…”

Adherence and persistence rates of major antidiabetic medications: a review

“…The persistence of once-daily (QD) DPP4 inhibitors was comparable to that of twice-daily (BID) DPP4 inhibitors (HR [95% CI] of discontinuation for BID regimen: 1.022 [0.994–1.050], p = 0.1187) [ 59 ]. Similarly, the difference between the adherence rates of BID regimen and QD regimen was not significant (OR [95% CI] of adherence for BID regimen: 0.945 [0.780–1.145], p = 0.5636) [ 59 ].…”

“…The persistence of once-daily (QD) DPP4 inhibitors was comparable to that of twice-daily (BID) DPP4 inhibitors (HR [95% CI] of discontinuation for BID regimen: 1.022 [0.994–1.050], p = 0.1187) [ 59 ]. Similarly, the difference between the adherence rates of BID regimen and QD regimen was not significant (OR [95% CI] of adherence for BID regimen: 0.945 [0.780–1.145], p = 0.5636) [ 59 ]. On the other hand, QD regimen showed significantly higher adherence and persistence rates than once-weekly (QW) regimen (HR [95% CI] of discontinuation for QW regimens: 1.699 [1.585–1.822], p < 0.0001; OR [95% CI] of adherence for QW regimen: 0.029 [0.024–0.036], p < 0.0001) [ 59 ].…”

Considerations for transition from subcutaneous to oral prophylaxis in the treatment of hereditary angioedema

“…HAE management should be periodically reviewed and discussed with the patient [ 3 ]. Although findings of studies involving other diseases differ on the optimal route and frequency of administration for maximal treatment adherence [ 28 – 30 ], a qualitative review of 102 articles demonstrated that convenience of administration is likely to have a favorable effect on adherence [ 31 ].…”