IMPACT OF MEDICATION ADHERENCE ON CLINICAL AND ECONOMIC OUTCOMES IN TYPE 2 DIABETES: A SCOPING REVIEW OF REAL-WORLD EVIDENCE
Author(s)
Xintian Wu, PharmD Candidate;
University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA
University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA
OBJECTIVES: To evaluate the impact of adherence to antidiabetic agents, including oral hypoglycemic agents (OAD) and glucose-lowering agents (GLA), on various clinical and economic outcomes among persons with Type 2 Diabetes Mellitus (T2DM).
METHODS: We conducted a scoping literature review of articles involving real-world adherence by focusing data from secondary sources, including electronic medical records and claims data. Full text articles were identified in PubMed, EMBASE, and Web of Science databases using the following keywords: compliance, adherence, administrative claims, real-world, and observational. Among 1505 articles initially retrieved, we identified 12 studies in T2DM that examined the impact of adherence to antidiabetic agents and endpoints including mortality, weight loss, glycemic control, healthcare resource utilization (HCRU) and costs.
RESULTS: Across multiple studies, patients with high adherence had improved clinical outcomes and lower HCRU and cost. For example, a study based upon data from a single managed care insurance plan in the Western US found that every 10% increase in adherence (using the proportion of days covered, PDC) resulted in a 0.1% decrease in glycosylated hemoglobin (HbA1c) levels. Similar results were observed in a study of Medicare Advantage enrollees receiving canagliflozin where adherent patients (PDC >=80%) had significantly greater reductions in HbA1c levels than those who had PDC<80% (1.17% vs. 0.73% reductions, respectively). A large healthcare database study in Switzerland observed a 10% reduction in mortality among patients who were adherent (PDC >=80%) to OAD versus non-adherent individuals. A US-based study observed that patients’ adherent to GLAs had significantly lower probability of hospitalization (22.71% vs 17.65%) and emergency department visits (45.61% vs 38.47%) compared with non-adherent patients.
CONCLUSIONS: Numerous studies have demonstrated that adherence to antidiabetic agents in patients with T2DM are associated with beneficial effects for a variety of outcomes, highlighting the importance of interventions to maximize adherence to ensure optimal outcomes in patients with T2DM.
METHODS: We conducted a scoping literature review of articles involving real-world adherence by focusing data from secondary sources, including electronic medical records and claims data. Full text articles were identified in PubMed, EMBASE, and Web of Science databases using the following keywords: compliance, adherence, administrative claims, real-world, and observational. Among 1505 articles initially retrieved, we identified 12 studies in T2DM that examined the impact of adherence to antidiabetic agents and endpoints including mortality, weight loss, glycemic control, healthcare resource utilization (HCRU) and costs.
RESULTS: Across multiple studies, patients with high adherence had improved clinical outcomes and lower HCRU and cost. For example, a study based upon data from a single managed care insurance plan in the Western US found that every 10% increase in adherence (using the proportion of days covered, PDC) resulted in a 0.1% decrease in glycosylated hemoglobin (HbA1c) levels. Similar results were observed in a study of Medicare Advantage enrollees receiving canagliflozin where adherent patients (PDC >=80%) had significantly greater reductions in HbA1c levels than those who had PDC<80% (1.17% vs. 0.73% reductions, respectively). A large healthcare database study in Switzerland observed a 10% reduction in mortality among patients who were adherent (PDC >=80%) to OAD versus non-adherent individuals. A US-based study observed that patients’ adherent to GLAs had significantly lower probability of hospitalization (22.71% vs 17.65%) and emergency department visits (45.61% vs 38.47%) compared with non-adherent patients.
CONCLUSIONS: Numerous studies have demonstrated that adherence to antidiabetic agents in patients with T2DM are associated with beneficial effects for a variety of outcomes, highlighting the importance of interventions to maximize adherence to ensure optimal outcomes in patients with T2DM.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO90
Topic
Clinical Outcomes
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)