Patient Adherence Improves Glycemic Control

Rhee, Mary K.; Slocum, Wrenn; Ziemer, David C.; Culler, Steven D.; Cook, Curtiss B.; El‐Kebbi, Imad M.; Gallina, Daniel L.; Barnes, Claire S.; Phillips, Lawrence S.

doi:10.1177/0145721705274927

Cited by 297 publications

(250 citation statements)

References 77 publications

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“…Rhee et al also showed an increase of 0.12% in A1c for each missed visit. 28 These studies are consistent with our findings that 10% of patients were non-adherent to visits, and visit non-adherence was associated with worse glycemic control.…”

Section: Discussionsupporting

confidence: 92%

“…While there are many studies evaluating the processes of care, [23][24][25][26] few studies relate these processes of care to outcomes, i.e., relating lack of testing, monitoring, or intensification with ultimate control of risk factors. 20,[27][28][29] We were unable to find any studies that evaluated visit adherence in relation to lipid or blood pressure control in diabetic adults. Two studies have evaluated the effects of appointment adherence on glycemic control.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies have evaluated the effects of appointment adherence on glycemic control. 28, 29 Karter et al 29 found 13% of From claims data, we determined overall burden of co-morbidity, using ICD-9 codes and patient demographics to create resource utilization band (RUB) categories using a formula developed at Johns Hopkins University. 16 We then grouped the resultant eight categories into three categories corresponding to low, medium, and high comorbidity patients missed >30% of appointments over 1 year, which was associated with a 0.70%-0.79% higher A1c compared to their visitcompliant counterparts.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Missed Opportunities in Diabetes Management: A Longitudinal Assessment of Factors Associated with Sub-optimal Quality

et al. 2008

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Missed Opportunities in Diabetes Management: A Longitudinal Assessment of Factors Associated with Sub-optimal Quality

et al. 2008

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“…On average, half the patients prescribed medications for modifiable risk factors common to people with diabetes discontinue therapy within 12 months of treatment initiation (6). Poorly compliant patients miss scheduled appointments for diabetes-related monitoring and treatment (7), and this is associated with poor glucose control (7,8).…”

Section: Diabetes Care 35:1279-1284 2012mentioning

confidence: 99%

“…Karter et al (7) reported that missing scheduled medical appointments was associated with higher HbA 1c levelsda predictor of mortalitydand with poor oral medication refill adherence. Rhee et al (8) found that appointment keeping and medication adherence were each independently associated with HbA 1c levels and that those with both risk factors had the highest HbA 1c levels.…”

Section: Mortalitymentioning

confidence: 99%

The impact of treatment non-compliance on mortality in people with type 1 diabetes

Currie

Peyrot

Morgan³

et al. 2013

Journal of Diabetes and its Complications

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OBJECTIVEdTo assess the association of compliance with treatment (medication and clinic appointments) and all-cause mortality in people with insulin-treated type 2 diabetes.RESEARCH DESIGN AND METHODSdData were extracted from U.K. general practice records and included patients (N = 15,984) who had diagnostic codes indicative of type 2 diabetes or who had received a prescription for an oral antidiabetic agent and were treated with insulin. Records in the 30 months before the index date were inspected for clinical codes (recorded at consultation) indicating medication noncompliance or medical appointment nonattendance. Noncompliance was defined as missing more than one scheduled visit or having at least one provider code for not taking medications as prescribed. Relative survival postindex date was compared by determining progression to all-cause mortality using Cox proportional hazards models.RESULTSdThose identified as clinic nonattenders were more likely to be smokers, younger, have higher HbA 1c , and have more prior primary care contacts and greater morbidity (P , 0.001). Those identified as medication noncompliers were more likely to be women (P = 0.001), smokers (P = 0.014), and have higher HbA 1c , more prior primary care contacts, and greater morbidity (all P , 0.001). After adjustment for confounding factors, medication noncompliance (hazard ratio 1.579 [95% CI 1.167-2.135]), clinic nonattendance of one or two missed appointments (1.163 [1.042-1.299]), and clinic nonattendance of greater than two missed appointments (1.605 [1.356-1.900]) were independent risk factors for all-cause mortality.CONCLUSIONSdMedication noncompliance and clinic nonattendance, assessed during routine care by primary care physicians or their staff, were independently associated with increased all-cause mortality in patients with type 2 diabetes receiving insulin.

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An Intervention to Overcome Clinical Inertia and Improve Diabetes Mellitus Control in a Primary Care Setting

Ziemer¹,

Doyle²,

Barnes³

et al. 2006

Arch Intern Med

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106

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Background: Although clinical trials have shown that proper management of diabetes can improve outcomes, and treatment guidelines are widespread, glycated hemoglobin (HbA1c) levels in the United States are rising. Since process measures are improving, poor glycemic control may reflect the failure of health care providers to intensify diabetes therapy when indicated-clinical inertia. We asked whether interventions aimed at health care provider behavior could overcome this barrier and improve glycemic control.Methods: In a 3-year trial, 345 internal medicine residents were randomized to be controls or to receive computerized reminders providing patient-specific recommendations at each visit and/or feedback on performance every 2 weeks. When glucose levels exceeded 150 mg/dL (8.33 mmol/L) during visits of 4038 patients, health care provider behavior was characterized as did nothing, did anything (any intensification of therapy), or did enough (if intensification met recommendations).Results: At baseline, residents did anything for 35% of visits and did enough for 21% of visits when changes in therapy

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Patient Adherence Improves Glycemic Control

Abstract: Keeping more appointments and taking diabetes medications as directed were associated with substantial improvements in HbA1c. Efforts to enhance glycemic outcomes should include emphasis on these simple but critically important aspects of patient adherence.

Cited by 297 publications

References 77 publications

Missed Opportunities in Diabetes Management: A Longitudinal Assessment of Factors Associated with Sub-optimal Quality

Missed Opportunities in Diabetes Management: A Longitudinal Assessment of Factors Associated with Sub-optimal Quality

The impact of treatment non-compliance on mortality in people with type 1 diabetes

An Intervention to Overcome Clinical Inertia and Improve Diabetes Mellitus Control in a Primary Care Setting

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