Antihypertensive and Lipid-Lowering Medication Adherence in Young Adults With Youth-Onset Type 2 Diabetes
Authors' conclusion
These findings suggest that adherence to BP- and lipid-lowering medications was very poor in this cohort. To improve medication adherence and prevent early vascular events, approaches that identify and address medication concerns and unmet social needs are needed.
Study context
- Population
- Young adults with youth-onset T2D and hypertension, nephropathy or dyslipidemia receiving diabetes care in their communities; iCount, 2017–2019; mean [SD] age 26.12 [2.51] years, 65.43% womenof 381 in iCount
- Participants
- 243 adults
- Exposure
- Low adherence vs high adherence to blood pressure (BP)- and lipid-lowering medications
- Outcome
- BP- and lipid-lowering medication adherence (low <80% of pills; high ≥80%)
Methodological details3 monthly unannounced pill counts at 2 time points 1 year apart, within observational phase of TODAY study, Data analyzed September 2022 to September 2023
- 3 monthly unannounced pill counts at 2 time points 1 year apart
- Within observational phase of TODAY study
- Data analyzed September 2022 to September 2023
Main finding
As reported in the abstract
Low adherence to BP-lowering medication, among 196 with hypertension or nephropathy
157
80.1%
Low adherence to lipid-lowering medication, among 146 with dyslipidemia
137
93.8%
High adherence to lipid-lowering medication, among 146 with dyslipidemia
9
6.2%
Observational data: associations, not effects.
Further findings
Age, low vs high adherence (hypertension or nephropathy) · younger with low adherence
P = 0.005
Diabetes duration, low vs high adherence · shorter with low adherence
P = 0.03
Factors associated with 1-year medication adherence (hypertension or nephropathy) · 1 year follow-up
| OR (95% CI) | P value | ||
|---|---|---|---|
| ≥1 unmet social needWorse adherence · adjusted multivariable analyses | 0.20 (0.05–0.65) | P = 0.04 | |
| Medication concernsWorse adherence · adjusted multivariable analyses | 0.63 (0.40–0.96) | P = 0.01 | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | Low adherence | High adherence | P value |
|---|---|---|---|
| HbA1c, low vs high adherenceHigher with low adherence · mean | 10.33% (SD 2.66 percentage points) | 8.85% (SD 2.39 percentage points) | P = 0.001 |
| No high school diploma, low vs high adherence | 10.83% | 0 events | P = 0.004 |
| Medication necessity score (BP-lowering), high vs low adherenceHigher with high adherence · unadjusted analyses · mean | 13.89 (SD 9.15) | 16.87 (SD 6.78) | P = 0.03 |
Low adherence to oral hypoglycemic agents, among 103 with low BP-medication adherence using them
- Low adherence to oral hypoglycemic agents
- 83 (80.58%)
Factors associated with 1-year medication adherence (hypertension or nephropathy) · 1 year follow-up
- Diabetes distress, self-efficacy, depressive and anxiety symptoms, and self-management support not associated with 1-year adherence
Original publication
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