Patterns of Adherence to Oral Hypoglycemic Agents and Glucose Control among Primary Care Patients with Type 2 Diabetes

Abstract

Researchers sought to examine whether there are patterns of oral hypoglycemic-agent adherence among primary-care patients with type 2 diabetes that are related to patient characteristics and clinical outcomes. Longitudinal analysis via growth curve mixture modeling was carried out to classify 180 patients who participated in an adherence intervention according to patterns of adherence to oral hypoglycemic agents across 12 weeks. Three patterns of change in adherence were identified: adherent, increasing adherence, and nonadherent. Global cognition and intervention condition were associated with pattern of change in adherence (p < .05). Patients with an increasing adherence pattern were more likely to have an Hemoglobin A_1c (HbA_1c) < 7%; adjusted odds ratio = 14.52, 95% CI (2.54, 82.99) at 12 weeks, in comparison with patients with the nonadherent pattern. Identification of patients with type 2 diabetes at risk of nonadherence is important for clinical prognosis and the development and delivery of interventions.

Keywords:

• adherence
• diabetes mellitus
• glycemic control
• primary health care
• randomized controlled trials

Funding

This study was supported in part by two grants from the National Institute of Mental Health: R21 MH094940 and R34 MH085880. Dr. Small was supported by grant SES-1260782 from the Measurement, Methodology and Statistics Program of the U.S. National Science Foundation.