title: Difficulty adhering to antidiabetic treatment: factors associated with persistence and compliance.
abstract: OBJECTIVE
  This study aimed to assess the 1-year treatment persistence and compliance of new oral antidiabetic drug (OAD) users with their treatment, and to identify the factors associated with both persistence and compliance.
  
  
  METHODS
  This population-based cohort study of new OAD users aged 18 years or above used the Quebec health insurance board databases. Those having a prescription filled for antidiabetic treatment during the period leading up to the 1-year anniversary of their first claim were considered to be persistent with their antidiabetic treatment. Of these patients, individuals with a medication possession ratio (MPR) greater or equal to 80% for OAD or insulin were deemed compliant. Also identified were the characteristics associated with both outcomes, using a multivariate logistic regression model.
  
  
  RESULTS
  Our cohort consisted of 151,173 individuals, 119,832 (79.3%) of whom were considered persistent. Of these, 93,418 (78.0%) were also deemed compliant. Persistence and compliance were associated with older ages, living in a rural region, low socioeconomic status, having the first OAD prescribed by a general practitioner and a history of using five different drugs or more. People were less likely to be persistent and compliant if their initial OAD was a secretagogue and if they had consulted a physician eight times or more during the year prior to starting treatment.
  
  
  CONCLUSIONS
  One year after OAD treatment initiation, 21% had discontinued their treatment and 22% of those still being treated were non-compliant. These results could help to tailor interventions aimed at optimizing the use of OAD treatments.
authors.affiliation: Faculty of Pharmacy, Université Laval, Québec, QC, Canada. line.guenette@pha.ulaval.ca
authors.forename: L
authors.initials: L
authors.lastname: Guénette
authors.forename: J
authors.initials: J
authors.lastname: Moisan
authors.forename: M-C
authors.initials: MC
authors.lastname: Breton
authors.forename: C
authors.initials: C
authors.lastname: Sirois
authors.forename: J-P
authors.initials: JP
authors.lastname: Grégoire
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011792:Quebec / Q000453:epidemiology; D016903:Drug Monitoring
chemical_list: D007004:Hypoglycemic Agents