Medication adherence and glycemic control among newly diagnosed diabetes patients

Abstract

BackgroundPoor medication adherence can have negative consequences for the patients, the provider, the physician, and the sustainability of the healthcare system. To our knowledge, the association between medication adherence and glycemic control among newly diagnosed diabetes patients has not been studied. This study aims to bridge the gap.MethodThis is a retrospective cohort study of 2463 patients managed in the National Healthcare Group in Singapore with newly diagnosed diabetes. Patients were followed up for the first two years from their first medication dispensed for measuring medication adherence, proportion of days covered (PDC); and for another three years for investigating outcomes of glycemic control, emergency department visit, and hospitalization. Multivariable regressions were performed to study the association between medication adherence and the outcomes as well as the risk factors of poor adherence.ResultsThe prevalence of medication adherence (PDC≥80%) was 65.0% (95% CI 63.1% to 66.9%) among newly diagnosed diabetes patients in Singapore. Male, Indian, or patients without hypertension or dyslipidemia were associated with poorer medication adherence. The HbA1c level of poor adherent patients (PDC <40%) increased by 0.4 (95% CI 0.2 to 0.5) over the two years, and they were also more likely to have hospitalization (OR 2.6,95% CI 1.7 to 3.8) or emergency department visit (OR 2.4,95% CI 1.7 to 3.4) compared with the fully adherent patients (PDC=100%).ConclusionsThe medication adherence in the early stage of diabetes is important for maximizing the effectiveness of pharmaceutical therapy. Health policies or interventions targeting the improvement of medication adherence among newly diagnosed diabetes patients are in need.

Adherence to medical follow‐up recommendations reduces hospital admissions: Evidence from diabetic patients in France

“…Diabetic patients with a lower adherence to medical follow-up have higher risks of diabetes complications (Grintsova, Maier, & Mielck, 2014), resulting in a higher risk of hospital admission (Andrade, Rapp, & Sevilla-Dedieu, 2018;Wagner et al, 2001), unplanned hospitalizations (Dusheiko, Gravelle, Martin, Rice, & Smith, 2011), and readmission (Rubin, 2015). Patients with poorly controlled diabetes may present repeatedly to the emergency department (Yan et al, 2017), whereas those with regular glycemic control (Lin, Sun, Heng, Chew, & Chong, 2017) and influenza vaccination (Vamos et al, 2016) have fewer hospital admissions. Dynamic models provide more convincing evidence because they consider that some medical follow-up needs of diabetic patients can be provided as inpatient care.…”

ANTIHIPERGLICEMIC THERAPY COMPLIANCE WITH HbA1C LEVELS IN TYPE 2 DIABETES MELLITUS PATIENTS AMONG PEKANBARU PROLANIS PARTICIPANTS

“…This study aims to analyze the relationship of adherence to the use of antihyperglycemic drugs with controlling DM Type 2, especially HbA1c levels in participants in the Chronic Disease Management Program (Prolanis) in Pekanbaru. 3,4,5…”

Beliefs about medicines as mediators in medication adherence in type 2 diabetes

“…Adherence to medication is required in T2DM treatment regimen and contributes to disease control being associated with decreased blood glycaemic levels (de Vries McClintock, Morales, Small, & Bogner, 2016;Lin, Sun, Heng, Chew, & Chong, 2017) and less hospitalization in newly diagnosed patients (Lin et al, 2017). Besides, medication adherence facilitates the control of other comorbidities associated with diabetes, such as hypertension and dyslipidaemia, and thereby contributes to a better quality of life decreasing the risk of microvascular and macrovascular complications, as well as mortality and health care costs (Kennedy-Martin, Boye, & Peng, 2017;Polonsky & Henry, 2016;Simpson, Lin, & Eurich, 2016).…”