Persistence and adherence to oral antidiabetics: a population-based cohort study

Simard, Pierre; Presse, Nancy; Roy, Louise; Dorais, Marc; White-Guay, Brian; Räkel, Agnès; Perreault, Sylvie

doi:10.1007/s00592-014-0692-x

Cited by 36 publications

(76 citation statements)

References 34 publications

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“…The 12 remaining articles were retrieved in full and screened for eligibility. Of those, 2 met eligibility criteria (Desai et al, 2014;Simard et al, 2015). Additionally, searching the reference lists of retrieved studies identified 2 further studies which were eligible for inclusion in this review (Dixon et al, 2004;Nelson et al, 2011).…”

Section: Search Resultsmentioning

confidence: 99%

“…Additional data necessary for meta-analyses was obtained from corresponding authors of 4 eligible studies (of 6 authors contacted) (Desai et al, 2014;Farley et al, 2012;Kreyenbuhl et al, 2010;Simard et al, 2015). Funnel plots were generated for each analysis, and visual inspection of these provided no indication of publication bias Diabetes medication adherence in schizophrenia 13 MD, mood disorder; OAD, oral antidiabetics; P-NOS, psychosis not otherwise specified; SZ, schizophrenia; SZ-AF, schizoaffective disorder Diabetes medication adherence in schizophrenia 15…”

Section: Search Resultsmentioning

confidence: 99%

“…Among these studies, 4 compared daily adherence in 19,367 people with schizophrenia to 170,853 people without schizophrenia (Desai et al, 2014;Kreyenbuhl et al, 2010;Nelson et al, 2011;Simard et al, 2015). Daily adherence in the non-schizophrenia samples was 72.5% (95% CI=66.4% to 78.6%, Q=1365, I 2 =99.78).…”

Section: Daily Adherence Ratesmentioning

confidence: 99%

“…Seven studies reported days-per-year adherence across 32,080 patients with schizophrenia (Desai et al, 2014;Dolder et al, 2003;Farley et al, 2012;Hansen et al, 2012;Kreyenbuhl et al, 2010;Nelson et al, 2011;Simard et al, 2015). These were calculated from prescription fill rates, using medication possession ratios (MPRs), Percentage of Days Covered (PDCs), or Cumulative Mean Gap Ratios (CMGRs) over a 1-2 year period (see Table 1).…”

Section: Daily Adherence Ratesmentioning

confidence: 99%

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Are people with schizophrenia adherent to diabetes medication? A comparative meta-analysis

Gorczynski

Firth

Stubbs

et al. 2017

Psychiatry Research

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. Are people with schizophrenia adherent to diabetes medication? A comparative meta-analysis. Psychiatry Research, 250,[17][18][19][20][21][22][23][24] https://doi.org/10.1016/j.psychres.2017.01.049Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections. General rightsCopyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights.•Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research.•You may not further distribute the material or use it for any profit-making activity or commercial gain •You may freely distribute the URL identifying the publication in the Research Portal Take down policy If you believe that this document breaches copyright please contact librarypure@kcl.ac.uk providing details, and we will remove access to the work immediately and investigate your claim. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. AbstractIndividuals living with schizophrenia are 2-3 times more likely to experience type 2 diabetes mellitus. Diabetes medication adherence is essential to reduce morbidity and mortality in this population. We conducted a meta-analysis of diabetes medication adherence among people with schizophrenia, and compared this to those without schizophrenia. A systematic search strategy was used to identify all articles reporting adherence to diabetes medications among patients with schizophrenia. In total, 10 unique studies reporting data from 33,910 people with schizophrenia were included. Random effects meta-analysis showed people with schizophrenia adhered to medication on 77.3% of days prescribed (n=32080, 95%CI=73.6%-81%, I²=99.2%,), and adhered on 4.6% more days per year than those without schizophrenia (p<0.01, 95%CI=2.4%-6.7%, I²=92.5%, schizophrenia n=19367, controls=170,853).Furthermore, 56% of individuals with schizophrenia (n=33680) were considered "adherent"(i.e. >80% adherence over 12-24 month) to diabetes medication, which was signifi...

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Section: Search Resultsmentioning

confidence: 99%

Section: Search Resultsmentioning

confidence: 99%

Section: Daily Adherence Ratesmentioning

confidence: 99%

Section: Daily Adherence Ratesmentioning

confidence: 99%

See 2 more Smart Citations

Are people with schizophrenia adherent to diabetes medication? A comparative meta-analysis

Gorczynski

Firth

Stubbs

et al. 2017

Psychiatry Research

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“…32 The complexity of the regimens used, the presence of comorbidities that introduce additional pill-burden, and the lack of understanding about the long-term consequences of inadequate treatment for an often asymptomatic condition like hypertension contribute to nonadherence. The recent, comprehensive review by Hyman and Pavlik 33 underscores the remarkable range in the prevalence of nonadherence, ranging from as low as 7 to as high as 66%.…”

Section: Role Of Medication Nonadherence and Nonpersistencementioning

confidence: 99%

Resistant Hypertension

Townsend

Epstein

2016

Hypertension

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H igh blood pressure (BP) is the leading risk factor for premature death and disability-adjusted life years in the world. 1 The development of a large pharmaceutical base from which to manage patients with hypertension in addition to many patient years of clinical trial experience have made it possible to successfully manage many of these patients. Nonetheless, many questions remain, particularly with respect to the optimal BP goal in the general population of hypertensive patients, patients with comorbidities like diabetes mellitus, and those with previous target organ damage such as stroke.Recent meta-analyses confirm that lower systolic and diastolic BP levels are associated with substantial reductions in important health outcomes such as death, coronary heart disease, and stroke in general populations 2,3 and in patients with diabetes mellitus. 4,5 In contrast, the ACCORD study (Action to Control Cardiovascular Risk in Diabetes) failed to support the postulate that lower is better. The ACCORD trial tested a systolic BP goal of 120 mm Hg versus 140 mm Hg in type 2 diabetics with hypertension 6 and did not find a significant difference in the primary outcome, a composite of death and nonfatal heart attack and stroke. Similarly, the SPS3 trial (Secondary Prevention of Small Subcortical Strokes) evaluated BP goals in patients with a previous lacunar stroke testing a systolic goal of 130 to 149 mm Hg versus <130 mm Hg.7 This trial also did not demonstrate significant reductions in ischemic stroke or intracranial hemorrhage in the more intensivetreated group. On the contrary, the SPRINT (Systolic Blood Pressure Intervention Trial) did show a significant improvement in the primary outcome, a pentad of heart attack, stroke, acute coronary syndrome, hospitalized heart failure, and cardiovascular death 8 in the intensive (<120 mm Hg) versus standard (<140 mm Hg) treatment groups.Guideline committees have the charge of proposing goal BP values in patients with hypertension, despite the challenges attending the questions of optimal treatment goal, particularly with comorbidities. Irrespective of the proposed goal BP value, there are patients who do not achieve these goals despite usage of substantial amounts of medication. The SPRINT findings are provocative and suggest there is benefit in pursuing lower than currently advocated BP goals. In this review, we will address how SPRINT findings may prompt a re-evaluation of how we define resistant hypertension (RHTN), how we measure BP in practice, what process are at play in those who do not achieve goal BP values, and what therapies we use to pursue lower BP goals. DefinitionsMany terms have been used over the past decade to describe aspects of RHTN. The basic definition of drug RHTN consists of office, or clinic, systolic BPs of ≥140 mm Hg, diastolic BPs of ≥90 mm Hg, or an elevation of both, on at least 3 antihypertensive medications from different drug classes.9-11 Pseudo-RHTN is characterized by patients who fulfill the definition of RHTN above, but have controlled BP ...

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Association of Second-line Antidiabetic Medications With Cardiovascular Events Among Insured Adults With Type 2 Diabetes

et al. 2018

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IMPORTANCE Understanding cardiovascular outcomes of initiating second-line antidiabetic medications (ADMs) may help inform treatment decisions after metformin alone is not sufficient or not tolerated. To date, no studies have compared the cardiovascular effects of all major second-line ADMs during this early decision point in the pharmacologic management of type 2 diabetes. OBJECTIVE To examine the association of second-line ADM classes with major adverse cardiovascular events. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study among 132 737 insured adults with type 2 diabetes who started therapy with a second-line ADM after taking either metformin alone or no prior ADM. This study used 2011-2015 US nationwide administrative claims data. Data analysis was performed from January 2017 to October 2018. EXPOSURES Dipeptidyl peptidase 4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose cotransporter 2 (SGLT-2) inhibitors, thiazolidinediones (TZDs), basal insulin, and sulfonylureas or meglitinides (both referred to as sulfonylureas hereafter). The DPP-4 inhibitors served as the comparison group in all analyses. MAIN OUTCOMES AND MEASURES The primary outcome was time to first cardiovascular event after starting the second-line ADM. This composite outcome was based on hospitalization for the following cardiovascular conditions: congestive heart failure, stroke, ischemic heart disease, or peripheral artery disease. RESULTS Among 132 737 insured adult patients with type 2 diabetes (men, 55%; aged 45-64 years, 58%; white, 63%), there were 3480 incident cardiovascular events during 169 384 person-years of follow-up. Patients were censored after the first cardiovascular event, discontinuation of insurance coverage, transition from International Classification of Diseases, Ninth Revision (ICD-9) to end of ICD-9 coding, or 2 years of follow-up. After adjusting for patient, prescriber, and health plan characteristics, the risk of composite cardiovascular events after starting GLP-1 receptor agonists was lower than DPP-4 inhibitors (hazard ratio [HR], 0.78; 95% CI, 0.63-0.96), but this finding was not significant in all sensitivity analyses. Cardiovascular event rates after starting treatment with SGLT-2 inhibitors (HR, 0.81; 95% CI, 0.57-1.53) and TZDs (HR, 0.92; 95% CI, 0.76-1.11) were not statistically different from DPP-4 inhibitors. The comparative risk of cardiovascular events was higher after starting treatment with sulfonylureas (HR, 1.36; 95% CI, 1.23-1.49) or basal insulin (HR, 2.03; 95% CI, 1.81-2.27) than DPP-4 inhibitors.

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Persistence and adherence to oral antidiabetics: a population-based cohort study

Abstract: Non-persistence and non-adherence to OAD therapy were common, although re-initiation rate was high. OAD classes, drug copayments, comorbidities and co-medications may help identifying those who were more likely to benefit from counseling.

Cited by 36 publications

References 34 publications

Are people with schizophrenia adherent to diabetes medication? A comparative meta-analysis

Are people with schizophrenia adherent to diabetes medication? A comparative meta-analysis

Resistant Hypertension

Association of Second-line Antidiabetic Medications With Cardiovascular Events Among Insured Adults With Type 2 Diabetes

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