Connie Mah Trinacty|Alyce S. Adams|Stephen B. Soumerai|Fang Zhang|James B. Meigs|John D. Piette|Dennis Ross?Degnan
Racial differences in long-term adherence to oral antidiabetic drug therapy: a longitudinal cohort study
Harvard Pilgrim Health Care|Harvard University|Kaiser Permanente|Harvard Pilgrim Health Care|Harvard University|Harvard Pilgrim Health Care|Harvard University|Harvard Pilgrim Health Care|Harvard University|Massachusetts General Hospital|Harvard University|VA Center for Clinical Management Research|University of Michigan–Ann Arbor|Harvard Pilgrim Health Care|Harvard University
adherence oral antidiabetic medications often suboptimal adherence differences may contribute health disparities black diabetes patients including higher microvascular event rates greater complicationrelated disability earlier mortalityin longitudinal retrospective cohort study used 10 years patientlevel claims electronic medical record data 11199212312001 assess differences short longterm adherence oral antidiabetic medication among 1906 newly diagnosed adults diabetes 26 black 74 white managed care setting members prescription drug coverage four main outcome measures included 1 time diabetes diagnosis first prescription oral antidiabetic medication 2 primary adherence time first prescription prescription fill 3 time discontinuation oral antidiabetic medication first prescription 4 longterm adherence amount dispensed versus amount prescribed 24month followup first oral antidiabetic medication prescriptionblack patients likely whites initiate oral therapy fill first prescription experienced higher rates medication discontinuation hr 18 95 ci 12 27 less adherent time blackwhite differences increased first six months therapy stabilized thereafter patients initiated sulfonylureas significant blackwhite differences adherence levels constant throughout followup patients initiated metformin therapyracial differences adherence oral antidiabetic drug therapy persist even equal access medication early continued emphasis adherence initiation therapy may reduce persistent racial differences medication use clinical outcomes