Effect of Medication Nonadherence on Hospitalization and Mortality Among Patients With Diabetes Mellitus
Ho, P et al
Arch Intern Med 2006;166:1836-1841
The results of this study can be condensed into two points:
- Noncompliance with diabetes treatment is prevalent
- Noncompliance with diabetes treatment is associated with increased risk of hospitalization and death
Data
Ho and colleagues retrospectively studied 11,532 patients with diabetes mellitus, calculating adherence as the proportion of days covered (PDC) for filled prescriptions of oral hypoglycemics, antihypertensives, and statins and defining nonadherence as PDC< 80%. The primary outcomes were all-cause hospitalization and all-cause mortality between January 2004 and April 2005.
21.3% of patients were noncompliant. This group, which tended to be younger and have fewer comorbidities compared with adherent patients, had higher all-cause hospitalization (23.2% vs 19.2%) and higher all-cause mortality (5.9% vs 4.0%).
Commentary
As was true with Ho and colleagues’ post-MI treatment compliance study, the results here are not surprising but are convincing affirmations of the significant prevalence and consequences of nonadherence and are evidence of the need for further research and pragmatic solutions to this clinical problem.
