Anastasia-Stefania Alexopoulos1,2, William S Yancy1,3,4, David Edelman1,3, Cynthia J Coffman1,5, Amy S Jeffreys1, Matthew L Maciejewski1,6, Corrine I Voils7,8, Nicole Sagalla1,2, Anna Barton Bradley9, Moahad Dar10,11, Stéphanie B Mayer12,13, Matthew J Crowley1,2. 1. Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC, USA. 2. Department of Medicine, Division of Endocrinology, Duke University Medical Center, Durham, NC, USA. 3. Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, USA. 4. Duke Diet and Fitness Center, Durham, NC, USA. 5. Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA. 6. Department of Population Health Sciences, Duke University Medical Center, Durham, NC, USA. 7. William S. Middleton Memorial Veterans Hospital, Madison, WI, USA. 8. Department of Surgery, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA. 9. Richmond Diabetes and Endocrinology, Bon Secours Medical Group, Richmond, VA, USA. 10. Division of Endocrinology and Metabolism, East Carolina University, Greenville NC, USA. 11. Greenville Veterans Affairs Health Care Center, Greenville, NC, USA. 12. Hunter Holmes McGuire Veterans Affairs Medical Center, Division of Endocrinology and Metabolism, Richmond, VA, USA. 13. Virginia Commonwealth University, Division of Endocrinology and Metabolism, Richmond, VA, USA.
Abstract
OBJECTIVES: The medication effect score reflects overall intensity of a diabetes regimen by consolidating dosage and potency of agents used. Little is understood regarding how medication intensity relates to clinical factors. We updated the medication effect score to account for newer agents and explored associations between medication effect score and patient-level clinical factors. METHODS: Cross-sectional analysis of baseline data from a randomized controlled trial involving 263 Veterans with type 2 diabetes and hemoglobin A1c levels ≥8.0% (≥7.5% if under age 50). Medication effect score was calculated for all patients at baseline, alongside additional measures including demographics, comorbid illnesses, hemoglobin A1c, and self-reported psychosocial factors. We used multivariable regression to explore associations between baseline medication effect score and patient-level clinical factors. RESULTS: Our sample had a mean age of 60.7 (SD = 8.2) years, was 89.4% male, and 57.4% non-White. Older age and younger onset of diabetes were associated with a higher medication effect score, as was higher body mass index. Higher medication effect score was significantly associated with medication nonadherence, although not with hemoglobin A1c, self-reported hypoglycemia, diabetes-related distress, or depression. DISCUSSION: We observed several expected associations between an updated medication effect score and patient-level clinical factors. These associations support the medication effect score as an appropriate measure of diabetes regimen intensity in clinical and research contexts.
OBJECTIVES: The medication effect score reflects overall intensity of a diabetes regimen by consolidating dosage and potency of agents used. Little is understood regarding how medication intensity relates to clinical factors. We updated the medication effect score to account for newer agents and explored associations between medication effect score and patient-level clinical factors. METHODS: Cross-sectional analysis of baseline data from a randomized controlled trial involving 263 Veterans with type 2 diabetes and hemoglobin A1c levels ≥8.0% (≥7.5% if under age 50). Medication effect score was calculated for all patients at baseline, alongside additional measures including demographics, comorbid illnesses, hemoglobin A1c, and self-reported psychosocial factors. We used multivariable regression to explore associations between baseline medication effect score and patient-level clinical factors. RESULTS: Our sample had a mean age of 60.7 (SD = 8.2) years, was 89.4% male, and 57.4% non-White. Older age and younger onset of diabetes were associated with a higher medication effect score, as was higher body mass index. Higher medication effect score was significantly associated with medication nonadherence, although not with hemoglobin A1c, self-reported hypoglycemia, diabetes-related distress, or depression. DISCUSSION: We observed several expected associations between an updated medication effect score and patient-level clinical factors. These associations support the medication effect score as an appropriate measure of diabetes regimen intensity in clinical and research contexts.
Authors: Jeannie Tay; Campbell H Thompson; Natalie D Luscombe-Marsh; Thomas P Wycherley; Manny Noakes; Jonathan D Buckley; Gary A Wittert; William S Yancy; Grant D Brinkworth Journal: Diabetes Obes Metab Date: 2017-12-20 Impact factor: 6.577
Authors: Jorge L Gross; Caroline K Kramer; Cristiane B Leitão; Neil Hawkins; Luciana V Viana; Beatriz D Schaan; Lana C Pinto; Ticiana C Rodrigues; Mirela J Azevedo Journal: Ann Intern Med Date: 2011-05-17 Impact factor: 25.391
Authors: Robert B Dorman; Federico J Serrot; Christopher J Miller; Bridget M Slusarek; Barbara K Sampson; Henry Buchwald; Daniel B Leslie; John P Bantle; Sayeed Ikramuddin Journal: Ann Surg Date: 2012-02 Impact factor: 12.969
Authors: Matthew C Riddle; Walter T Ambrosius; David J Brillon; John B Buse; Robert P Byington; Robert M Cohen; David C Goff; Saul Malozowski; Karen L Margolis; Jeffrey L Probstfield; Adrian Schnall; Elizabeth R Seaquist Journal: Diabetes Care Date: 2010-05 Impact factor: 19.112
Authors: Nicola N Zammitt; George Streftaris; Gavin J Gibson; Ian J Deary; Brian M Frier Journal: Diabetes Technol Ther Date: 2011-03-17 Impact factor: 6.118
Authors: Cody Durrer; Sean McKelvey; Joel Singer; Alan M Batterham; James D Johnson; Kelsey Gudmundson; Jay Wortman; Jonathan P Little Journal: Nat Commun Date: 2021-09-10 Impact factor: 17.694
Authors: Daniel J Cox; Tom Banton; Matthew Moncrief; Mark Conaway; Anne Diamond; Viola Holmes; Joyce Green Pastors; Anne Wolf; Kun Fang; Anthony McCall Journal: BMJ Open Diabetes Res Care Date: 2020-12