Initial Therapy, Regimen Change, and Persistence in a Spanish Cohort of Newly Treated Type 2 Diabetes Patients: A Retrospective, Observational Study Using Real-World Data

Aida Moreno-Juste, Beatriz Poblador-Plou, Mercedes Aza-Pascual-Salcedo, Francisca González-Rubio, Sara Malo, Julián Librero López, Victoria Pico-Soler, Eva Giménez Labrador, Sara Mucherino, Valentina Orlando, Enrica Menditto, Alexandra Prados-Torres and Antonio Gimeno-Miguel
Additional contact information
Aida Moreno-Juste: Servicio Aragonés de Salud (SALUD), 50009 Zaragoza, Spain
Beatriz Poblador-Plou: EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
Mercedes Aza-Pascual-Salcedo: Servicio Aragonés de Salud (SALUD), 50009 Zaragoza, Spain
Francisca González-Rubio: Servicio Aragonés de Salud (SALUD), 50009 Zaragoza, Spain
Sara Malo: Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
Julián Librero López: Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), ISCIII, 28222 Madrid, Spain
Victoria Pico-Soler: Servicio Aragonés de Salud (SALUD), 50009 Zaragoza, Spain
Eva Giménez Labrador: EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
Sara Mucherino: CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, 80131 Napoli NA, Italy
Valentina Orlando: CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, 80131 Napoli NA, Italy
Enrica Menditto: CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, 80131 Napoli NA, Italy
Alexandra Prados-Torres: EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
Antonio Gimeno-Miguel: EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain

IJERPH, 2020, vol. 17, issue 10, 1-16

Abstract: The World Health Organization considers the non-adherence to medication a significant issue with global impact, especially in chronic conditions such as type 2 diabetes. We aim to study antidiabetic treatment initiation, add-on, treatment switching, and medication persistence. We conducted an observational study on 4247 individuals initiating antidiabetic treatment between 2013 and 2014 in the EpiChron Cohort (Spain). We used Cox regression models to estimate the likelihood of non-persistence after a one-year follow-up, expressed as hazard ratios (HRs). Metformin was the most frequently used first-line antidiabetic (80% of cases); combination treatment was the second most common treatment in adults aged 40–79 years, while dipeptidyl peptidase-4 inhibitors were the second most common in individuals in their 80s and over, and in patients with renal disease. Individuals initiated on metformin were less likely to present addition and switching events compared with any other antidiabetic. Almost 70% of individuals initiated on monotherapy were persistent. Subjects aged 40 and over (HR 0.53–0.63), living in rural (HR 0.79) or more deprived areas (HR 0.77–0.82), or receiving polypharmacy (HR 0.84), were less likely to show discontinuation. Our findings could help identify the population at risk of discontinuation, and offer them closer monitoring for proper integrated management to improve prognosis and health outcomes.

Keywords: adherence; antidiabetics; comorbidity; diabetes; persistence; real-world data; Spain; treatment patterns (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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