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Administrative data feasible for tracking persistence, adherence to insulin treatment and real-world outcomes
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PHILADELPHIA — Researchers found that tracking administrative data was a reasonable and effective method for gauging real-world persistence and adherence to therapy and associated outcomes in insulin-treated patients.
Wenhui Wei, PhD, MS, MBA, researcher for Sanofi-Aventis, and colleagues pooled patient-level data from three published observational studies, all of which utilized information from the IMPACT national managed care database and examined patients with type 2 diabetes who were previously treated with oral antidiabetes drugs and/or GLP-1 analogs and initiating therapy with insulin glargine (Lantus, Sanofi-Aventis) or insulin detemir (Levemir, Novo Nordisk).
A total of 4,804 patients (mean age, 56 years; 43% women; mean HbA1c, 9.37%) taking an average of 2.05 oral antidiabetes drugs at baseline were included in the study. Of these, 2,257 patients were using an insulin glargine disposable pen and 1,915 were using an insulin glargine vial. Another 632 were using an insulin detemir pen.
“We did this study to examine associations between treatment persistence/adherence and real-world outcomes among type 2 diabetic patients initiating insulin therapy,” Wei said during the presentation.
The researchers evaluated the association between treatment persistence, defined as taking a medication without interruption, and adherence, defined as medication possession ratio >80%, and HbA1C, HbA1C reduction from baseline, hypoglycemia-related event rate, health care utilization and costs.
It was found that a higher treatment persistence and adherence were linked to significantly lower HbA1c levels and greater reductions from baseline HbA1c levels. Drug costs were also higher, but these were counterbalanced by the observed decrease in hospitalizations and ED visits. Hypoglycemia was associated with higher likelihood of insulin discontinuation.
“Now that we know they are linked, the next question is what we can do to improve patients’ adherence and persistence to insulin treatment,” Wei said.
For more information:
Wei W. Abstract#13-OR. Presented at: the American Diabetes Association’s 72nd Scientific Sessions; June 8-12, 2012; Philadelphia.
Disclosure: Dr.Wei is an employee, stock/shareholder and spouse of an employee and stock/shareholder for Sanofi-Aventis. Dr. Pan reports employment with PRO Unlimited, and ties with Sanofi-Aventis. Dr. Xie and Dr. Baser report consultancy research for Sanofi-Aventis and employment with STATinMED