Factors associated with antidiabetic medication non-adherence in patients with incident comorbid depression.
OBJECTIVE
To identify factors associated with antidiabetic drug (AD) non-adherence among patients with type 2 diabetes and depression.


METHODS
We conducted a population-based retrospective cohort study among new AD users with a diagnosis of depression following AD initiation. We used public health insurance data from Quebec. The dependent variable was non-adherence (i.e., <90% of days covered by ≥1AD) in the year after a depression diagnosis. Different sociodemographic, clinical and medication-related variables were assessed as potential factors of non-adherence to AD treatment. We performed univariate and multivariate logistic regressions.


RESULTS
We identified 3106 new users of ADs with a diagnosis of depression between 2000 and 2006. Of these individuals, 52% were considered non-adherent to their ADs. Baseline non-adherence, younger age, the addition of another AD to the initial treatment, <4 drug claims, visits with several different physicians, high socioeconomic status, and a small number of diabetes complications were associated with AD non-adherence.


CONCLUSIONS
The factors identified in the present study may help clinicians recognize patients with type 2 diabetes and incident depression at increased risk for non-adherence. In these patients, close follow-up and targeted interventions could help improve adherence to AD treatment, improve glycemic control and reduce complications.
Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre - Université Laval, Québec, QC, Canada.
Carlotta
C
Lunghi
Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre - Université Laval, Québec, QC, Canada.
Arsène
A
Zongo
Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre - Université Laval, Québec, QC, Canada.
Jocelyne
J
Moisan
Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre - Université Laval, Québec, QC, Canada.
Jean-Pierre
JP
Grégoire
Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre - Université Laval, Québec, QC, Canada. Electronic address: Line.Guenette@pha.ulaval.ca.
Line
L
Guénette
D000067575:Administrative Claims, Healthcare; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D015994:Incidence; D038801:International Classification of Diseases; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D008960:Models, Psychological; D011792:Quebec / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
D007004:Hypoglycemic Agents
Associated factors; Depression; Determinants; Healthcare administrative claims; Medication adherence; Type 2 diabetes mellitus