Compliance and persistence with concomitant statin and oral antihyperglycemic therapy.

Qiaoyi Zhang, Changgeng Zhao, Michael J Davies, Larry Radican, Thomas Seck
Author Information
  1. Qiaoyi Zhang: Global Health Outcomes, Merck Sharp and Dohme Corp, Whitehouse Station, NJ 08889, USA. qiaoyi_zhang@merck.com

Abstract

OBJECTIVES: To compare compliance and persistence with statin and oral antihyperglycemic therapies in patients with type 2 diabetes who received concomitant therapy.
STUDY DESIGN: Retrospective cohort study using a large US commercial claims database.
METHODS: Patients with type 2 diabetes and dispensed prescriptions for both statin and oral antihyperglycemic therapies on the same date in 2006 (index date = first date of such dispensing) were included in the analysis (N = 52,414). Patients were required to have continuous enrollment in the database for 1 year prior to (baseline) and 2 years after (follow-up) index date. The 2-year medication possession ratio (MPR) was compared between statin and oral antihyperglycemic therapy. For the persistence analysis, treatment discontinuation was defined by a gap >30 days between the last date of supply from previous dispensing and subsequent refill. The likelihood of discontinuation of statin versus oral antihyperglycemic therapy was estimated by fitting a robust Cox proportional hazards regression model, adjusted for baseline variables.
RESULTS: The 2-year MPR was 70% for statin and 78% for oral antihyperglycemic therapy (P <.0001). The proportion of patients with a 2-year MPR >80% was 52% for statin and 63% for oral antihyperglycemic therapy (P <.0001). The median time to discontinuation of statin was significantly shorter compared with oral antihyperglycemic therapy (284 vs 495 days, P <.001). There was a greater risk to discontinue statin than oral antihyperglycemic therapy (adjusted hazard ratio: 1.47 [95% confidence interval 1.45-1.48]).
CONCLUSIONS: Compliance and persistence with statin therapy significantly lagged behind oral antihyperglycemic therapy in patients with type 2 diabetes who were treated concomitantly with both therapies.

MeSH Term

Aged
Anticholesteremic Agents
Cohort Studies
Confidence Intervals
Diabetes Mellitus, Type 2
Drug Therapy, Combination
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypercholesterolemia
Hypoglycemic Agents
Male
Medication Adherence
Middle Aged
Proportional Hazards Models
Retrospective Studies
Time Factors
United States

Chemicals

Anticholesteremic Agents
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypoglycemic Agents

Word Cloud

Created with Highcharts 10.0.0statinoralantihyperglycemictherapydatepersistence2therapiespatientstypediabetes12-yearMPRdiscontinuationP<concomitantdatabasePatientsindex=dispensinganalysisbaselinecompareddaysadjusted0001significantlyComplianceOBJECTIVES:comparecompliancereceivedSTUDYDESIGN:RetrospectivecohortstudyusinglargeUScommercialclaimsMETHODS:dispensedprescriptions2006firstincludedN52414requiredcontinuousenrollmentyearprioryearsfollow-upmedicationpossessionratiotreatmentdefinedgap>30lastsupplyprevioussubsequentrefilllikelihoodversusestimatedfittingrobustCoxproportionalhazardsregressionmodelvariablesRESULTS:70%78%proportion>80%52%63%mediantimeshorter284vs495001greaterriskdiscontinuehazardratio:47[95%confidenceinterval45-148]CONCLUSIONS:laggedbehindtreatedconcomitantly

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