Related Experiment Videos
Utilization patterns and medication adherence in patients with type 2 diabetes: variations based on type of pharmacy
Iftekhar Kalsekar1, Courtney Sheehan, Amy Peak
1Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Butler University, Indianapolis, IN 46208, USA. ikalseka@butler.edu
Background:
Independent pharmacies have demonstrated a positive effect on patient satisfaction, dispensing errors, and patient consultation/counseling. However, there is a lack of studies demonstrating whether these benefits translate into outcomes such as medication adherence.
Objective:
To estimate the variations in utilization patterns and adherence to oral hypoglycemic agents (OHAs) based on type of pharmacy (chain/independent).
Methods:
A retrospective cohort design was used to meet the study objective. Newly diagnosed type 2 diabetes patients during a 4-year period were identified from a Medicaid claims database. The provider of the index prescription was classified as a chain or independent pharmacy. Utilization patterns (switching, augmentation, discontinuation, nonmodification) and adherence to OHAs (medication possession ratios) were computed for a 12-month follow-up period from the date of the index OHA prescription. A multivariate framework was used to estimate the effect of type of pharmacy on utilization patterns and adherence after controlling for confounding variables.
Results:
A total of 2696 newly diagnosed type 2 diabetes patients were identified (independent pharmacy=987; chain pharmacy=1709). Utilization patterns were significantly different between the 2 groups with patients filling their prescription at a chain pharmacy 1.3 times more likely to augment therapy as compared to patients filling prescriptions at an independent pharmacy (P=.035). Independent sample t tests indicated that adherence to OHAs (Mean+/-SD) was significantly higher for patients filling their prescriptions at a independent pharmacy (0.90+/-0.13) as compared to those filling prescriptions at a chain pharmacy (0.88+/-0.13, P=.01). Results of a semi-log Ordinary Least Squares model also indicated that controlling for covariates, patients filling prescriptions at an independent pharmacy had significantly higher adherence to OHAs as compared to those filling prescriptions at a chain pharmacy (P=.02).
Conclusion:
Results of the study indicated that patients with type 2 diabetes who received their OHAs from an independent pharmacy have slightly higher adherence rates as compared to those filling their OHA prescriptions at a chain pharmacy.
Related Concept Videos
Dosage Regimen: Individualization
Analysis Methods of Pharmacokinetic Data: Model and Model-Independent Approaches
The model approach uses mathematical models to describe changes in drug concentration over time. Pharmacokinetic models help characterize drug behavior in patients, predict drug concentration in the body fluids, calculate optimum dosage regimens, and evaluate the risk of toxicity. However, ensuring that the model fits the experimental data accurately...
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
Insulin Formulations: Types and Delivery
Short-acting insulins are divided into rapid-acting...
Model-Independent Approaches for Pharmacokinetic Data: Noncompartmental Analysis
One important characteristic of noncompartmental analyses is that drug exposure increases proportionally with increasing doses. This relationship...
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...