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Depression in patients with type 2 diabetes: impact on adherence to oral hypoglycemic agents

Iftekhar D Kalsekar1, Suresh S Madhavan, Mayur M Amonkar

  • 1Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Butler University, Indianapolis, IN 46208, USA. ikalseka@butler.edu

The Annals of Pharmacotherapy
|March 23, 2006
PubMed
Abstract

Insights

Depression significantly lowers adherence to oral hypoglycemic agents in newly diagnosed type 2 diabetes patients. Integrating depression screening and treatment is crucial for effective diabetes management.

Area of Science:

  • Endocrinology and Metabolism
  • Psychiatry and Mental Health
  • Health Services Research

Background:

  • Adherence to oral hypoglycemic agents (OHAs) is critical for managing type 2 diabetes and preventing complications.
  • Depression is a common comorbidity that may affect treatment adherence.

Purpose of the Study:

  • To investigate the relationship between depression and OHA adherence in patients newly diagnosed with type 2 diabetes.
  • To quantify the impact of depression on medication adherence.

Main Methods:

  • Utilized a Medicaid claims database to identify 1326 newly diagnosed type 2 diabetes patients over four years.
  • Assessed depression using ICD-9-CM codes and calculated OHA adherence via prescription refill data (MPR-1, MPR-2) over 12 months.
  • Employed multivariate analysis to control for confounders including demographics, comorbidities, and diabetes severity.

Main Results:

  • Patients with depression (n=471) exhibited lower OHA adherence (MPR-1 86%, MPR-2 66%) compared to non-depressed patients (n=855; MPR-1 89%, MPR-2 73%).
  • Multivariate analysis confirmed depression as a significant predictor, with depressed patients showing 3-6% lower adherence.

Conclusions:

  • Depression substantially impairs OHA adherence in type 2 diabetes patients.
  • Routine depression screening and integrated treatment are recommended for comprehensive type 2 diabetes care.

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