Impact of Medication Adherence on Diabetic Patients

Chronic illness treatment typically involves some level of long-term use of pharmacotherapy. While these medications may prove efficacious in contesting the disease, their full benefits often go unmet, because nearly 50% of patients do not to take the medications as prescribed.

There are a slew of factors reported as contributing to poor medication adherence:

· Subpar health literacy

· Lack of outside involvement in the treatment decision making process

· Prescription of complex drug regimens

· Communication barriers, specifically regarding adverse effects

· Provision of care by multiple physicians

· Limited office visit time

· Limited access to care

· Lack of health information technology

Samir Bansilal, MD, MS, division of Cardiology at Mount Sinai School of Medicine, New York, NY, will discuss his assessment of the impact of medication adherence on long-term outcomes in patients afflicted with diabetes on Saturday, March 14 at the American College of Cardiology meeting.

Previous FREEDOM and BARI trials had revealed the significant decrease in adherence of recommended therapies in diabetic patients.

As such, Bansilal and his team studied the association between levels of medication adherence and long term MACE in high risk DM patients. Analyzing data from a total of 19,962 diabetes patients older than 55 year suffering from hypertension or dyslipidemia, Bansilal’s team scrutinized their insurers’ claims from January 2010 to December 2011

Using proportion of days covered for 1 year following the first refill, the researchers organized their patients into 3 groups: as fully adherent, partially adherent, or non-adherent.

The team used the cox proportional model to study and compare the time to MACE.

They reported that of the study cohort, 5,645 (28%) were classified as non-adherent, 7,571 (38%) as partially adherent, and 6,746 (34%) as fully adherent.

The results indicated shockingly low rates at 34% of adherence to both statin and ACEI. Furthermore, diabetes patients who were either fully or partially adherent were found to have significantly lower event rates than non-adherent patients.

Bansilal noted that efforts towards improving adherence in DM subjects could certainly result in substantial reductions in MACE.