title: Patterns of Adherence to Oral Hypoglycemic Agents and Glucose Control among Primary Care Patients with Type 2 Diabetes.
abstract: Researchers sought to examine whether there are patterns of oral hypoglycemic-agent adherence among primary-care patients with type 2 diabetes that are related to patient characteristics and clinical outcomes. Longitudinal analysis via growth curve mixture modeling was carried out to classify 180 patients who participated in an adherence intervention according to patterns of adherence to oral hypoglycemic agents across 12 weeks. Three patterns of change in adherence were identified: adherent, increasing adherence, and nonadherent. Global cognition and intervention condition were associated with pattern of change in adherence (p < .05). Patients with an increasing adherence pattern were more likely to have an Hemoglobin A1c (HbA1c) < 7%; adjusted odds ratio = 14.52, 95% CI (2.54, 82.99) at 12 weeks, in comparison with patients with the nonadherent pattern. Identification of patients with type 2 diabetes at risk of nonadherence is important for clinical prognosis and the development and delivery of interventions.
authors.affiliation: a Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine , University of Pennsylvania; Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania.
authors.forename: Heather F
authors.initials: HF
authors.lastname: de Vries McClintock
authors.affiliation: b Department of Biostatistics and Epidemiology, Perelman School of Medicine , University of Pennsylvania.
authors.forename: Knashawn H
authors.initials: KH
authors.lastname: Morales
authors.affiliation: c Department of Statistics, The Wharton School , University of Pennsylvania.
authors.forename: Dylan S
authors.initials: DS
authors.lastname: Small
authors.affiliation: a Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine , University of Pennsylvania; Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania.
authors.forename: Hillary R
authors.initials: HR
authors.lastname: Bogner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011320:Primary Health Care; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: adherence; diabetes mellitus; glycemic control; primary health care; randomized controlled trials