Abstract
The aim of this study was to examine a potential association between: (1) refill adherence to antihyperglycaemic drugs and glucose control, and (2) adherence to antihyperglycaemic and cardiovascular drugs for the same patients. Consecutive patients with type 2 diabetes at six Swedish health centres were included. Refill adherence was determined from repeat prescriptions. Satisfactory refill adherence was defined as the percentage of the patients with refills covering ≥80% of the prescribed treatment time. A total of 994 prescriptions were collected from 422 patients, 346 patients had antihyperglycaemic drugs (mean HbA1c 6.5%) and 76 were on diet and exercise but not on drugs (mean HbA1c 6.2%) (P = 0.0098). A total of 257 patients (74%) had satisfactory refill adherence. Mean HbA1c for the adherent patients was 6.5% and for the non-adherent patients 6.8% (P = 0.025). For patients on insulin only, 69% had satisfactory refill adherence with mean HbA1c 6.6% compared to 7.3% (P = 0.005) for the non-adherent patients. Ninety-two percent of the patients with satisfactory refill adherence to antihyperglycaemic agents were also adherent to cardiovascular drugs compared to 62% among those who were non-adherent to antihyperglycaemic drugs (P < 0.001). Patients with satisfactory refill adherence have lower HbA1c-levels and higher adherence to cardiovascular drugs than non-adherent patients.
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References
International Diabetes Foundation. Diabetes e-atlas. http://www.eatlas.idf.org
Anonymous (2003) Adherence to long-term therapies. Evidence for action.WHO Report, Geneva
Cramer JA (2004) A systematic review of adherence with medications for diabetes. Diabetes care 27:1218–1224
Lindenmeyer A, Hearnshaw H, Vermire E, Van Royen P, Wens J, Biot Y (2006) Interventions to improve adherence to medication in people with type 2 diabetes mellitus: a review of the literature on the role of pharmacists. J Clin Pharm Ther 31:409–419
Andersson K, Melander A, Svensson C, Lind O, Nilsson JLG (2005) Repeat prescriptions—refill adherence in relation to patient and prescriber characteristics, reimbursement level and type of medication. Eur J Public Health 15:621–625
Steiner JF, Prochazka AV (1997) The assessment of refill compliance using pharmacy records: methods, validity and applications. J Clin Epidemiol 50:105–116
Jackevicius CA, Mamdani M, Tu JV (2002) Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA 288:462–467
Wei L, Wang J, Thompson P, Wong S, Struthers AD, MacDonald TM (2002) Adherence to statin treatment and readmission of patients after myocardial infarction: a six year follow-up study. Heart 288:229–233
Morningstar BA, Sketris IS, Kephart GC, Sclar DA (2002) Variation in pharmacy prescription refill adherence measures by type of oral antihyperglycaemic drug therapy in seniors in Nova Scotia, Canada. J Clin Pharm Ther 27:213–220
Donnan PT, MacDonald TM, Morris AD (2002) Adherence to prescribed oral hypoglycaemic medication in a population of patients with type 2 diabetes: a retrospective cohort study. Diabetic Med 19:279–284
Spoelstra JA, Stolk RP, Heerdink ER, Klungel OH, Erkens JA, Leufkens HGM, Grobbee DE (2003) Refill compliance in type 2 diabetes mellitus: a predictor of switching to insulin therapy. Pharmacoepidemiol Drug Saf 12:121–127
Kogut SJ, Andrade SE, Willey C, Larrat EP (2004) Nonadherence as a predictor of hypoglycemic drug therapy intensification (augmentation). Pharmacoepidemiol Drug Saf 13:591–598
Paes AH, Bakkker A, Soe-Agnie CJ (1998) Measurement of patient compliance. Pharm World Sci 20:73–77
Morris AD, Boyle DIR, McMahon AD, Greene SA, MacDonald TM, Newton RW, for the DART/MEMO Collaboration (1997) Adherence to insulin treatment, glycemic control, and ketoacidosis in insulin-dependent diabetes mellitus. Lancet 350:1505–1510
Lau DT, Nau DP (2004) Oral antihyperglycaemic medication nonadherence and subsequent hospitalization among individuals with type 2 diabetes. Diabetes Care 27:2149–2153
Kuo Y-F, Ray LA, Raji MA, Espino DV, Markides KS, Goodwin JS (2003) Inconsistent use of diabetes medications, diabetes complications and mortality in older Mexican Americans over a 7-year period. Diabetes Care 26:3054–3060
Veg A (2006) Teaching and learning in type 2 diabetes. The importance of self-perceived roles in disease management. Thesis, Faculty of Medicine, Uppsala University
Acknowledgments
We wish to thank the Skaraborg health centres at Billingen, Hentorp, Hjo, Norrmalm, Skara and Tibro for their collaboration and particularly the nurses Anna-Lena Allerth, Inger Andersson, Susanne Andersson, Åsa Breman, Anna-Karin Carlsson, Birgitta Fogelqvist, Gunnel Johansson, Lena Johansson, Maria Karlsson, Eija Kimari-Karlsson, Helén Kjällström-Silvén, Ragnhild Lundqvist, Anita Mehmer and Barbro Norén for recruiting the patients and collecting the prescription copies. Financial support from Skaraborg Research and Development Council is highly appreciated.
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Kindmalm, L., Melander, A. & Nilsson, J.L.G. Refill adherence of antihyperglycaemic drugs related to glucose control (HbA1c) in patients with type 2 diabetes. Acta Diabetol 44, 209–213 (2007). https://doi.org/10.1007/s00592-007-0006-7
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DOI: https://doi.org/10.1007/s00592-007-0006-7