OBJECTIVE: Although poor medication adherence may contribute to inadequate diabetes control, ways to feasibly measure adherence in routine clinical practice have yet to be established. The present study was conducted to determine whether pharmacy claims-based measures of medication adherence are associated with clinical outcomes in patients with diabetes. RESEARCH DESIGN AND METHODS: The study setting was a large, integrated delivery and financial system serving the residents of southeastern Michigan. The study population consisted of 677 randomly selected patients aged > or =18 years with a diagnosis of diabetes, hypercholesterolemia, and hypertension and who filled at least one prescription for either an antidiabetic, lipid-lowering, or antihypertensive drug in each of the 3 study years (1999-2001). The main outcome measures were HbA1c, LDL cholesterol levels, and blood pressure. RESULTS: Nonadherent patients had both statistically and clinically worse outcomes than adherent patients. Even after adjusting for demographic and clinical characteristics, nonadherence was significantly associated with HbA1c and LDL cholesterol levels. A 10% increase in nonadherence to metformin and statins was associated with an increase of 0.14% in HbA1c and an increase of 4.9 mg/dl in LDL cholesterol levels. Nonadherence to ACE inhibitors was not significantly associated with blood pressure. CONCLUSIONS: Claims-based measures of medication adherence are associated with clinical outcomes in patients with diabetes and may therefore prove to be useful in clinical practice. More research is needed on methods to introduce claims-based adherence measurements into routine clinical practice and how to use these measurements to effectively improve adherence and health outcomes in chronic care management.
OBJECTIVE: Although poor medication adherence may contribute to inadequate diabetes control, ways to feasibly measure adherence in routine clinical practice have yet to be established. The present study was conducted to determine whether pharmacy claims-based measures of medication adherence are associated with clinical outcomes in patients with diabetes. RESEARCH DESIGN AND METHODS: The study setting was a large, integrated delivery and financial system serving the residents of southeastern Michigan. The study population consisted of 677 randomly selected patients aged > or =18 years with a diagnosis of diabetes, hypercholesterolemia, and hypertension and who filled at least one prescription for either an antidiabetic, lipid-lowering, or antihypertensive drug in each of the 3 study years (1999-2001). The main outcome measures were HbA1c, LDL cholesterol levels, and blood pressure. RESULTS: Nonadherent patients had both statistically and clinically worse outcomes than adherent patients. Even after adjusting for demographic and clinical characteristics, nonadherence was significantly associated with HbA1c and LDL cholesterol levels. A 10% increase in nonadherence to metformin and statins was associated with an increase of 0.14% in HbA1c and an increase of 4.9 mg/dl in LDL cholesterol levels. Nonadherence to ACE inhibitors was not significantly associated with blood pressure. CONCLUSIONS: Claims-based measures of medication adherence are associated with clinical outcomes in patients with diabetes and may therefore prove to be useful in clinical practice. More research is needed on methods to introduce claims-based adherence measurements into routine clinical practice and how to use these measurements to effectively improve adherence and health outcomes in chronic care management.
Authors: Ken Kolodner; Richard B Lipton; Jennifer Elston Lafata; Carol Leotta; Joshua N Liberman; Elsbeth Chee; Christina Moon Journal: J Clin Epidemiol Date: 2004-09 Impact factor: 6.437
Authors: M R DiMatteo; C D Sherbourne; R D Hays; L Ordway; R L Kravitz; E A McGlynn; S Kaplan; W H Rogers Journal: Health Psychol Date: 1993-03 Impact factor: 4.267
Authors: Michael J Stirratt; Jacqueline Dunbar-Jacob; Heidi M Crane; Jane M Simoni; Susan Czajkowski; Marisa E Hilliard; James E Aikens; Christine M Hunter; Dawn I Velligan; Kristen Huntley; Gbenga Ogedegbe; Cynthia S Rand; Eleanor Schron; Wendy J Nilsen Journal: Transl Behav Med Date: 2015-07-09 Impact factor: 3.046
Authors: Alexander Turchin; Holly I Wheeler; Matthew Labreche; Julia T Chu; Merri L Pendergrass; Jonathan S Einbinder; Jonathan Seth Einbinder Journal: AMIA Annu Symp Proc Date: 2008-11-06
Authors: Zeina A Habib; Leonidas Tzogias; Suzanne L Havstad; Karen Wells; George Divine; David E Lanfear; Jeffrey Tang; Richard Krajenta; Manel Pladevall; L Keoki Williams Journal: Pharmacoepidemiol Drug Saf Date: 2009-06 Impact factor: 2.890
Authors: Wayne Katon; Joan Russo; Elizabeth H B Lin; Susan R Heckbert; Andy J Karter; Lisa H Williams; Paul Ciechanowski; Evette Ludman; Michael Von Korff Journal: Psychosom Med Date: 2009-10-15 Impact factor: 4.312