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- Title
Impact of Multiple Medication Use for Treatment of Diabetes and Lipid Disorders on Therapy Compliance, LDL, and HbA1c.
- Authors
Riedel, Aylin A.; Buysman, Erin K.; Arondekar, Bhakti; Horblyuk, Ruslan
- Abstract
We hypothesized that addition of Lipid Lower (LL) or Oral Antidiabetic (OAD) to current management for hyperlipidemia or diabetes could lead to reductions in compliance with prescribed medications and adverse outcomes. The purpose of this study was to assess the impact of addition of a second therapy (LL or OAD added to existing OAD or LL therapy) on compliance with medications and HbA1c and LDL laboratory results. A retrospective, administrative claims-based analysis using commercial and Medicaid enrollees in a large, US managed health care plan. Subjects with existing use of LL or OAD therapy who initiated new OAD or LL therapy during 1/1/2000 - 10/31/2005 were included. LDL and HbA1c laboratory results and change in Medication Possession Ratio (MPR) (percent of days with therapy coverage) were assessed. The study sample includes 34,721 subjects: 35% added OAD to existing LL therapy; 65% added LL to existing OAD therapy. The mean age was 55.5 years with 58.6% males. The addition of new therapy to existing therapy was associated with an 8% decrease in MPR of existing therapy. Decreases were greater among those adding OAD to LL therapy and who were less compliant (decreases in MPR ranged from -18% - -1% across quintiles of MPR.) Decreased MPR was significantly associated with a lower rate of achieving LDL and Ale goals during follow-up. Subjects with MPR in the lowest quintile were 50% less likely to achieve LDL or A1c goal compared to subjects with greatest compliance levels. This study identified a relationship between compliance with prescription drug regimen and achievement of LDL and HbA1c goal. Addition of OAD or LL therapy to existing LL or OAD therapy was associated with decreased compliance with both medications and the effect was most pronounced for patients with the lowest levels of compliance. These results indicate that polypharmacy may have an impact on disease management outcomes through the mediating factor of compliance and reducing polypharmacy pill burden may enhance compliance.
- Subjects
UNITED States; TREATMENT of diabetes; HYPOGLYCEMIC agents; HYPERLIPIDEMIA treatment; DRUGS; THERAPEUTICS
- Publication
Diabetes, 2007, Vol 56, pA553
- ISSN
0012-1797
- Publication type
Article