Factors Associated with Glucose-Lowering Drug Adherence Among U.S. Adults with Type 2 Diabetes
Author(s)
Niu S1, Alkhuzam K2, Huang W2, Tang H2, Varghese JS3, Jiao T4, Zhang Y5, Guo S6, Shao H7
1University of Florida, GAINESVILLE, FL, USA, 2University of Florida, Gainesville, FL, USA, 3Emory University, Atlanta, GA, USA, 4Complete HEOR Solutions (CHEORS), North Wales, PA, USA, 5Tulane University School of Public Health and Tropical Medicine, Metairie, LA, USA, 6University of Pittsburgh, Pittsburgh, PA, USA, 7University of Florida College of Pharmacy, Gainesville, FL, USA
Presentation Documents
OBJECTIVES:
Approximately 75–90% of people with type 2 diabetes (T2D) are treated with glucose-lowering drugs (GLDs) and Low drug adherence has been a persisting challenge in diabetes management. we aimed to identify factors associated with adherence to GLDs and investigate if these factors vary by class.METHODS:
Using serial cross-sectional data from adults with T2D in the 2010-2019 Medical Expenditure Panel Survey (MEPS; n = 9,961), we estimated drug adherence for seven therapeutic classes of GLDs (basal insulin, metformin, sulphonylureas, thiazolidinediones, DPP-4 inhibitors [DPP4i], GLP-1 receptor agonists [GLP1-RA], and SGLT2 inhibitors [SGLT2i]). We measured adherence using medication possession ratio (MPR, 0-1) over 12 months. We examined 36 potential predictors for drug adherence from four categories (demographics, socioeconomics, chronic conditions, and medication usage). We used multivariable linear regression models and performed stepwise selection to identify the factors associated with the overall MPR and MPRs separately by GLD class.RESULTS:
Mean MPR ranged from 0.52 for GLP1-RA to 0.69 for metformin, with 24.24–45.61% participants having MPR ≥0.8. Older age (per 10 years)(β=0.01 ), being white (β=0.04), having health insurance(β=0.06 private insurance, β=0.07 public insurance, ref=uninsured), diabetes duration over 10 years(β=0.02), lipid-lowering drugs use(β =0.05), anticoagulants use(β=0.03), antihypertensives use(β=0.03), antidepressants use(β=0.04), Sulphonylureas use(β=0.04) and Metformin use(β=0.06) were all associated with increased overall MPR. GLDs unit cost(per day)(β =-0.04) and antiarrhythmics (β=-0.05) use were associated with lower overall MPR. Factors that influence the adherence of individual GLD classes were slightly different from the factors for the overall MPR. Hypercholesterolemia was associated with lower MPR of Basal Insulin. Antiplatelet Agents use was associated with increased MPR of DPP4i. GLP-1RA and SGLT2i use were associated with lower MPR of other GLDs. CONCLUSIONS: We have identified factors associated with GLD adherence. The differences in factors that influence individual GLD adherence suggest different follow-up interventions to promote adherence among different GLD users.Conference/Value in Health Info
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
PCR153
Topic
Methodological & Statistical Research, Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Artificial Intelligence, Machine Learning, Predictive Analytics, Patient Behavior and Incentives
Disease
Drugs