title: Race and medication adherence and glycemic control: findings from an operational health information exchange.
abstract: The Central Indiana Beacon Community leads efforts for improving adherence to oral hypoglycemic agents (OHA) to achieve improvements in glycemic control for patients with type 2 diabetes. In this study, we explored how OHA adherence affected hemoglobin A1C (HbA1c) level in different racial groups. OHA adherence was measured by 6-month proportion of days covered (PDC). Of 3,976 eligible subjects, 12,874 pairs of 6-month PDC and HbA1c levels were formed between 2002 and 2008. The average HbA1c levels were 7.4% for African-Americans and 6.5% for Whites. The average 6-month PDCs were 40% for African-Americans and 50% for Whites. In mixed effect generalized linear regression analyses, OHA adherence was inversely correlated with HbA1c level for both African-Americans (-0.80, p<0.0001) and Whites (-0.53, p<0.0001). The coefficient was -0.26 (p<0.0001) for the interaction of 6-month PDC and African-Americans. Significant risk factors for OHA non-adherence were race, young age, non-commercial insurance, newly-treated status, and polypharmacy.
authors.affiliation: Regenstrief Institute, Inc., IN, USA.
authors.forename: Vivienne J
authors.initials: VJ
authors.lastname: Zhu
authors.forename: Wanzhu
authors.initials: W
authors.lastname: Tu
authors.forename: David G
authors.initials: DG
authors.lastname: Marrero
authors.forename: Marc B
authors.initials: MB
authors.lastname: Rosenman
authors.forename: J Marc
authors.initials: JM
authors.lastname: Overhage
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000208:ethnology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D063005:Health Information Systems; D006801:Humans; D007196:Indiana; D007348:Insurance, Health; D008297:Male; D008490:Medical Informatics; D055118:Medication Adherence / Q000208:ethnology; D008875:Middle Aged; D019338:Polypharmacy; D044465:White People; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin