Medication Adherence Affects Risk of New Diabetes Complications

Simpson, Scot H.; Lin, Min; Eurich, Dean T.

doi:10.1177/1060028016653609

Cited by 49 publications

(47 citation statements)

References 34 publications

(37 reference statements)

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“…A similar pattern was observed for nonadherence to antidiabetic drugs. Lower adherence to medications for hypertension and diabetes carries a higher risk of cardiovascular events including stroke . In line with our findings, younger age has been associated with lower medication adherence to antihypertensive and antidiabetic drugs in many countries …”

Section: Discussionsupporting

confidence: 91%

Previously undiagnosed risk factors and medication nonadherence are prevalent in young adults with first‐ever stroke

Sung

Lai

et al. 2017

Pharmacoepidemiology and Drug

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Section: Discussionsupporting

confidence: 91%

Previously undiagnosed risk factors and medication nonadherence are prevalent in young adults with first‐ever stroke

Sung

Lai

et al. 2017

Pharmacoepidemiology and Drug

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“…If an appreciation and understanding of patients’ preference for treatment can be gained and a patient-centered approach is used during clinical decision-making, then adherence is likely to improve [7]. If adherence can be increased, then improvements in diabetes-related outcomes will be likely, including improvements in glycemic control, and reductions in short-term and long-term diabetes-related complications, and healthcare resource utilization [10, 12, 14, 34–37]. Medication regimens with less frequent dosing regimen are associated with greater adherence to medication [38].…”

Section: Discussionmentioning

confidence: 99%

“…Medication adherence plays an essential role in overall glycemic control, and helps to reduce the risk of complications, to prevent premature mortality, and to lower overall healthcare costs [10–12]. Nevertheless, adherence rates as low as 45% have been reported among those with T2DM [13].…”

Section: Introductionmentioning

confidence: 99%

Glucagon-like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Naïve Patients with Type 2 Diabetes Mellitus: A Multinational Preference Study

Qin

Chen

Flood³

et al. 2017

Diabetes Ther

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IntroductionGlucagon-like peptide-1 receptor agonists (GLP-1RAs) differ in efficacy, side effects, dosing frequency, and device-related attributes. This study assessed the relative importance of treatment-related attributes in influencing preferences for GLP-1RAs among injection-naïve patients with type 2 diabetes mellitus (T2DM).MethodsInjection-naïve T2DM patients from five countries completed a Web-based discrete choice experiment (DCE) survey. Patients chose between hypothetical treatment profiles reflecting important and differentiating attributes of GLP-1RAs. Eight attributes were included: efficacy, side effects, device size, needle size, titration, preparation, evidence of long-term efficacy/safety, and dosing frequency. Odds ratios (ORs) and 95% confidence intervals were calculated using a conditional logit model to indicate the likelihood of choosing a treatment with a given attribute level versus a reference attribute level. The influence of individual attributes when considering full treatment profiles was examined using exenatide once weekly (QW) and liraglutide once daily (QD) as case examples.ResultsA total of 1482 patients with T2DM completed the DCE survey. Side effects, efficacy, and dosing frequency were the three most important attributes influencing preferences; needle size, device size, and required preparation were least important. Total sample analysis indicated that a profile of GLP-1RA approximating exenatide QW (single pen) was preferred over a profile approximating liraglutide QD (OR 3.36; p < 0.001), when efficacy was assumed to be equal.ConclusionThe most influential drivers of treatment preferences for a hypothetical GLP-RA profile were side effects, efficacy, and dosing frequency among injection-naïve T2DM patients. Preference elicitation can promote patient-centered care and inform new generations of T2DM treatments, which can lead to improved adherence and health outcomes.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0230-2) contains supplementary material, which is available to authorized users.

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“…If patients’ adherence to medication for T2DM can be improved, then improvements in diabetes-related outcomes are likely to occur, including improved glycemic control, reduced diabetes-related complications, and decreased healthcare resource utilization [20, 25, 26, 53–55]. …”

Section: Discussionmentioning

confidence: 99%

Glucagon-Like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Experienced Patients with Type 2 Diabetes Mellitus: A Preference Study in Germany and the United Kingdom

Qin

Chen

Flood³

et al. 2017

Diabetes Ther

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IntroductionThis study assessed the relative importance of treatment-related attributes in influencing patient preferences for glucagon-like peptide-1 receptor agonists (GLP-1RAs) among injection-experienced type 2 diabetes mellitus (T2DM) patients in Germany and the United Kingdom.MethodsT2DM patients experienced with injecting once-weekly (QW) exenatide or once-daily (QD) liraglutide completed an online discrete-choice experiment (DCE) survey. Patients chose between hypothetical blinded treatment profiles reflecting attributes of GLP-1RAs. The DCE survey included eight attributes: efficacy, side effects, device size, needle size, titration, injection preparation, long-term efficacy/safety, and dosing frequency. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a conditional logit model indicating the likelihood of choosing a treatment with a given attribute level versus a reference attribute level.Results510 GLP-1RA injection-experienced patients completed the survey; 45.3% respondents were being treated with exenatide QW and 54.7% respondents were being treated with liraglutide QD. In terms of GLP-1RA attributes, patients indicated a preference for a treatment with greater efficacy (i.e., a 1.5-point improvement in HbA1c) (OR 2.58; 95% CI 2.37, 2.80; p < 0.001), fewer side effects (OR 2.67; 95% CI 2.52, 2.82; p < 0.001), once-weekly rather than once-daily administration (OR 2.26; 95% CI 2.13, 2.39; p < 0.001), and the preparation required for a multi-use pen (OR 1.71; 95% CI 1.55, 1.88; p < 0.001). Needle size, device size, and titration were not significant drivers of patient preference.ConclusionsAmong GLP-1RA injection-experienced patients, key drivers of treatment preference for a hypothetical GLP-RA profile were side effects, efficacy, dosing frequency, and required preparation. Understanding patient preferences is important for optimizing treatment decision-making and improving treatment adherence. Funding: AstraZeneca.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0237-8) contains supplementary material, which is available to authorized users.

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Medication Adherence Affects Risk of New Diabetes Complications

Abstract: This study design addresses limitations of previous studies and found a small but significantly lower risk of new diabetes complications associated with good adherence to oral antidiabetic medications.

Cited by 49 publications

References 34 publications

Previously undiagnosed risk factors and medication nonadherence are prevalent in young adults with first‐ever stroke

Previously undiagnosed risk factors and medication nonadherence are prevalent in young adults with first‐ever stroke

Glucagon-like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Naïve Patients with Type 2 Diabetes Mellitus: A Multinational Preference Study

Glucagon-Like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Experienced Patients with Type 2 Diabetes Mellitus: A Preference Study in Germany and the United Kingdom

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