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Does adherence to medications for type 2 diabetes differ between individuals with vs without schizophrenia?
Julie Kreyenbuhl1, Lisa B Dixon, John F McCarthy
1Department of Psychiatry, Universityof Maryland School of Medicine, Baltimore, MD 21201, USA.jkreyenb@psych.umaryland.edu
Schizophrenia Bulletin
|August 23, 2008
Summary
Individuals with schizophrenia and type 2 diabetes showed better adherence to oral hypoglycemic medications. This finding suggests potential benefits from integrated care models for managing comorbid conditions in patients with schizophrenia.
Area of Science:
- Psychiatry
- Endocrinology
- Health Services Research
Background:
- Schizophrenia increases the risk of poor health outcomes and mortality.
- Inadequate self-management of co-occurring conditions like type 2 diabetes contributes to these risks.
- Medication adherence is crucial for managing type 2 diabetes effectively.
Purpose of the Study:
- To compare adherence to oral hypoglycemic medications in diabetes patients with and without comorbid schizophrenia.
- To identify factors associated with medication adherence in this patient population.
Main Methods:
- Retrospective analysis of Veterans Affairs (VA) health system administrative data.
- Identified patients with schizophrenia and type 2 diabetes (N=11,454) and a comparison group with diabetes only (N=10,560).
- Nonadherence defined as medication possession ratio < 80%.
Main Results:
- Poor adherence was less prevalent in diabetes patients with schizophrenia (43%) compared to those without (52%, P < .001).
- Schizophrenia was associated with a 25% lower likelihood of poor adherence (adjusted OR: 0.75).
- Factors associated with poorer adherence included Black race, homelessness, depression, substance use disorder, and medical comorbidity.
Conclusions:
- Despite overall low adherence, individuals with comorbid schizophrenia demonstrated better adherence to oral hypoglycemic medications.
- Integrated care or regular mental health contact may benefit diabetes self-management in patients with schizophrenia.
- Further research is needed to explore these potential benefits and optimize care delivery.
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