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Medication adherence affects treatment modifications in patients with type 2 diabetes
Jaco Voorham1, Flora M Haaijer-Ruskamp, Bruce H R Wolffenbuttel
1Department of Clinical Pharmacology, Faculty of Medical Science, University Medical Center Groningen, University of Groningen, The Netherlands. j.voorham@med.umcg.nl
Clinical Therapeutics
|March 15, 2011
Summary
Low medication adherence hinders intensifying glucose control in type 2 diabetes patients. However, it does not appear to affect antihypertensive treatment modifications, though it may lead to discontinuation.
Area of Science:
- Endocrinology
- Cardiology
- Pharmacology
Background:
- Type 2 diabetes management often involves insufficient treatment intensification despite uncontrolled risk factors.
- Medication adherence is frequently cited as a reason for undertreatment, but evidence is inconclusive.
Purpose of the Study:
- To investigate the impact of medication adherence on treatment modifications for hypertension and hyperglycemia in type 2 diabetes patients.
Main Methods:
- A cohort study of 11,268 Dutch primary care patients with type 2 diabetes was conducted.
- Medication adherence was assessed using medication possession ratio or length of last refill gap.
- Multilevel multinomial regression analysis examined associations between adherence and treatment modifications.
Main Results:
- Lower adherence to antihypertensive drugs correlated with increased discontinuation (OR 1.22) or dose decrease (OR 1.14).
- For glucose-regulating medications, lower adherence was associated with less frequent dose increases (OR 0.92) or additions (OR 0.90).
Conclusions:
- Low adherence impedes the intensification of glucose-lowering treatments in type 2 diabetes.
- Adherence does not appear to inhibit antihypertensive medication intensification but may lead to reduced or stopped treatment.
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