Race and medication adherence in Medicaid enrollees with type-2 diabetes.
OBJECTIVE
The association of medication adherence with race has been inadequately studied previously in type-2 diabetes patients. The study objective was to determine the association between race and medication adherence among type-2 diabetes patients.


METHODS
This was a retrospective cohort study, which compared medication adherence among different races of Medicaid insured patients with type-2 diabetes newly starting oral antidiabetic medication. A total of 1,527 African-American patients newly starting antidiabetic medication between July 2001 and June 2002 were compared with 1,128 white patients and 514 patients of other race. Medication adherence was measured as medication possession ratio using prescription refill patterns. Multivariate regression analyses were used to determine the difference in adherence rates adjusting for other covariates.


RESULTS
Medication adherence rate was significantly higher for whites [0.59 (0.31)] as compared to African Americans [0.54 (0.31), (p<0.05)]. In multivariate analyses, the adherence rate of African-American patients was found to be significantly lower by 12% as compared to whites after adjusting for other covariates. Metformin users were associated with a 62% decrease in adherence rate as compared with the sulfonylureas group (p<0.05).


CONCLUSIONS
The antidiabetic medication adherence was associated with race. Future research should investigate patient-related factors affecting medication adherence in type-2 diabetes patients.
Shenolikar
Rahul A
RA
Department of Pharmacy Practice and Administration, The Ohio State University College of Pharmacy, Columbus, OH, USA.
Balkrishnan
Rajesh
R
Camacho
Fabian T
FT
Whitmire
J Timothy
JT
Anderson
Roger T
RT
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008484:Medicaid; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology* / Q000523:psychology* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D014481:United States; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data
D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D008687:Metformin