Comparative adherence to diabetes drugs: An analysis of electronic health records and claims data

Diabetes Obes Metab. 2017 Aug;19(8):1184-1187. doi: 10.1111/dom.12931. Epub 2017 Apr 10.

Abstract

Non-adherence to medications is a major challenge in diabetes care. The objective of this brief report is to compare adherence rates for 6 major classes of diabetes medications: metformin, sulfonylurea, thiazolidinedione, basal insulin, DPP-4 inhibitors, and GLP-1 receptor agonists. We used a data source that linked electronic prescriptions with insurance claims to assess whether new electronic prescriptions for diabetes medications were followed by dispensing claims consistent with that prescription. After one year of follow-up, the daily medication possession probability (MPP) - a measure of overall adherence - at one year for sulfonylurea was 0.49 and for metformin was 0.46. Thiazolidinediones and basal insulin had a similar final daily MPP at 0.36 and 0.39, respectively, which was significantly lower than that for sulfonylurea or metformin (P < .05). GLP-1 receptor agonists and DPP-4 inhibitors were also comparable to one another at a final daily MPP of .30 and .21, respectively (P < .05 compared to any of the aforementioned drug classes). In summary, the rates at which diabetes drugs are prescribed, and the rates at which patients actually take them, differ substantially. Physicians should be aware of potentially significant challenges concerning adherence to newer agents.

Keywords: antidiabetic drug; observational study.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cohort Studies
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / metabolism
  • Dipeptidyl-Peptidase IV Inhibitors / administration & dosage
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use*
  • Electronic Prescribing
  • Female
  • Glucagon-Like Peptide-1 Receptor / antagonists & inhibitors*
  • Glucagon-Like Peptide-1 Receptor / metabolism
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / administration & dosage
  • Insulin / therapeutic use
  • Insurance, Pharmaceutical Services
  • Longitudinal Studies
  • Male
  • Medicare Part C
  • Medicare Part D
  • Medication Adherence*
  • Metformin / administration & dosage
  • Metformin / therapeutic use
  • Middle Aged
  • Practice Patterns, Physicians'*
  • Retrospective Studies
  • Sulfonylurea Compounds / administration & dosage
  • Sulfonylurea Compounds / therapeutic use
  • Thiazolidinediones / administration & dosage
  • Thiazolidinediones / therapeutic use
  • United States

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Glucagon-Like Peptide-1 Receptor
  • Hypoglycemic Agents
  • Insulin
  • Sulfonylurea Compounds
  • Thiazolidinediones
  • Metformin
  • 2,4-thiazolidinedione