THE RELATIONSHIP BETWEEN GLUCOSE-LOWERING MEDICATIONS, ADHERENCE, AND OUTCOMES IN PATIENTS WITH TYPE 2 DIABETES
Author(s)
Piercy J1, Milligan G1, Davies MJ2, Detournay B3, Orozco Beltran D4, Chubb B5, Bottomley JM6, Nicolucci A7, Jacob S8
1Adelphi Real World, Bollington, UK, 2University of Leicester, Leicester, UK, 3Cemka-Eval, Bourg-la-Reine, France, 4Centro de Salud Cabo Huertas, Alicante, Spain, 5Novo Nordisk Healthcare AG, Gatwick, UK, 6Amygdala Ltd, Letchworth Garden City, UK, 7Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy, 8Private Practice, Villingen-Schwenningen, Germany
OBJECTIVES: Adherent type 2 diabetes (T2DM) patients are more likely to have good glycaemic control than non-adherent patients, potentially resulting in better outcomes. We investigated the association between the number of glucose-lowering therapies, adherence and their impact on glycaemic control and quality of life (QoL). METHODS: Data were drawn from the 2013 Diabetes Disease Specific Programme, a large cross-sectional real-world survey of primary care physicians (PCP) and specialists and their patients consulting for diabetes. Physicians provided information regarding prescriptions, previous treatment and most recent HbAvalues. Patients completed the Morisky Measurement of Adherence Scale and the EQ-5D. Patients who had been on current treatment between 6 months and 5 years and had values for all variables were included. A linear Structural Equation Model was developed to explore the relationships between the number of oral and injectable diabetes medications per day, adherence, glycaemic control and QoL while adjusting for confounding factors relating to duration and type of medication, existing complications, concomitant conditions, demographic and lifestyle factors. RESULTS: (β=-0.10, p<0.001), lower HbAis associated with improved QoL (β=-0.019, p<0.001). CONCLUSIONS: Controlling for important clinical and demographic factors, a lower number of daily glucose-lowering therapies is associated with greater adherence which, in turn, is associated with better glycaemic control and improved QoL. Further research is required to investigate if these associations vary depending on the specific medication taken or other patient-related parameters not considered here.
Conference/Value in Health Info
2015-11, ISPOR Europe 2015, Milan, Italy
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PP4
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Diabetes/Endocrine/Metabolic Disorders
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