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Medication Adherence During Adjunct Therapy With Statins and ACE Inhibitors in Adolescents With Type 1 Diabetes
Elżbieta Niechciał1, Carlo L Acerini2, Scott T Chiesa3
1Department of Pediatric Diabetes, Endocrinology and Obesity, Poznan University of Medical Sciences, Poznan, Poland.
Diabetes Care
|February 29, 2020
Summary
Adolescents with type 1 diabetes showed good adherence to ACE inhibitors and statins in a clinical trial. However, adherence decreased over time, influenced by age and glycemic control.
Area of Science:
- Endocrinology
- Cardiology
- Pharmacology
Background:
- Suboptimal adherence to insulin is a significant challenge in adolescents with type 1 diabetes.
- Data on adherence to non-insulin adjunct medications in this population are lacking.
- This study addresses adherence to ACE inhibitors and statins in adolescents with type 1 diabetes.
Purpose of the Study:
- To assess adherence to ACE inhibitors and statins in adolescents with type 1 diabetes.
- To explore potential determinants of adherence to these medications.
- To evaluate adherence patterns over the course of a clinical trial.
Main Methods:
- The study involved 443 adolescents with type 1 diabetes in the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT).
- Participants received ACE inhibitors, statins, or both, alongside placebo for 2-4 years.
- Adherence was monitored every 3 months using the Medication Event Monitoring System (MEMS) and pill counts.
Main Results:
- Median adherence was 80.2% (MEMS) and 85.7% (pill count).
- Adherence significantly declined from initial visits (92.9% MEMS, 96.3% pill count) to the end of the trial (76.3% MEMS, 79.0% pill count).
- Older age, suboptimal baseline glycemic control, and country were associated with lower adherence.
Conclusions:
- Overall adherence to ACE inhibitors and statins was good, but a notable decline occurred over time.
- Older age and poorer baseline glycemic control predicted lower adherence.
- Reduced adherence was more common in participants who discontinued the trial.
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