Association of Medication Adherence With HbA1c Control Among American Indian Adults With Type 2 Diabetes Using Tribal Health Services
Authors' conclusion
Medication adherence was higher than that found in previous studies using self-report methods in American Indian populations, although a smaller proportion of patients had HbA1c at or below target relative to U.S. adults with T2D. Medication adherence was associated with improved HbA1c levels for most oral glucose-lowering medication classes. Future studies of American Indians should use both longitudinal prescription data from both electronic health records and pharmacy refills.
Study context
- Population
- American Indian adults with T2D using Choctaw Nation Health Services Authority and Pharmacies, with HbA1c data 2017–2018; medications at no costeligible
- Participants
- 4,560 adults
- Exposure
- Medication adherence and future HbA1c
- Outcome
- Association of medication adherence (PDC) in 2017 with HbA1c levels in 2018
- Follow-up
- 2018
Methodological detailselectronic health record data
- Electronic health record data
Main finding
As reported in the abstract
Higher average PDC in 2017 associated with lower HbA1c in 2018 (β)
−1.143
P < 0.001
Observational data: associations, not effects.
Further findings
HbA1c control in 2017
- HbA1c at or below target (≤7%)
- 32%
- Above target (>7 to ≤9%)
- 36%
- Uncontrolled (>9%)
- 32%
Adherence (PDC ≥0.80) by drug class · 2017
- Biguanides
- 66%
- Sulfonylureas
- 72%
- DPP-4i
- 75%
- SGLT2i
- 83%
HbA1c at or below target · 2017 to 2018
- Increased slightly from 2017 to 2018
- 32% to 42%
Original publication
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