Presentation (CTI)

OBJECTIVES: For many people with chronic conditions, taking medications for long time can be challenging. CarePath is a European initiative aiming to improve health outcomes in people with cardiometabolic conditions by integrating E-health and non-E-health interventions to support cardiometabolic pharmacotherapy persistence in three medication classes (glucagon-like peptide-1 agonists (GLP-1As), sodium-glucose cotransporter 2 inhibitors (SGLT2is). and lipid-lowering drugs (LLDs)). Understanding the current medication persistence of people with type 2 diabetes (T2D) in routine care clinical practice serves as the basis for early HTA assessment.
METHODS: The DIAMANT cohort, a cohort developed by PHARMO and maintained by STIZON, was used as the primary source of real world Dutch healthcare data. Inclusion was limited to the years 2015-2024. The medication persistence cut off in this study is 274 days (9 months) after last prescription received. Room for improvement was based on respective RCT medication persistence rates.
RESULTS: Inclusion criteria limited the original T2D cohort from 372,254 (48% female, mean age of 60 and median follow-up time of 12.6 (IQR = 8.4-17.1)) to 214,219 people with T2D (46% female, a mean age of 65 and median follow-up time of 6.1 years (IQR = 5.5-8.6)). During follow-up, 7.85%, 11.65% and 77.39% used GLP-1As, SLGT2is and LLDs, respectively. One year persistence of all drug classes was over 65% (GLP-1As = 67%, SGLT2is = 68% and LLDs = 65%). 5 year persistence was 54%, 62% and 51% for GLP-1As, SGLT2is and LLDs, respectively.
CONCLUSIONS: The 5 year persistence of all medications of interest being above 50% in this T2D cohort was high. These rates might be potentially explained by the strength of the Dutch T2D care, consisting of integrated care and a dedicated GP practice assistant for T2D (“Ketenzorg” and “POH DM”). This project is supported by the Innovative Health Initiative Joint Undertaking under grant agreement 101192133.