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医疗补助计划中2型糖尿病参保者的种族与药物依从性

Race and medication adherence in Medicaid enrollees with type-2 diabetes.

作者信息

Shenolikar Rahul A, Balkrishnan Rajesh, Camacho Fabian T, Whitmire J Timothy, Anderson Roger T

机构信息

Department of Pharmacy Practice and Administration, The Ohio State University College of Pharmacy, Columbus, OH, USA.

出版信息

J Natl Med Assoc. 2006 Jul;98(7):1071-7.

Abstract

OBJECTIVE

The association of medication adherence with race has been inadequately studied previously in type-2 diabetes patients. The study objective was to determine the association between race and medication adherence among type-2 diabetes patients.

METHODS

This was a retrospective cohort study, which compared medication adherence among different races of Medicaid insured patients with type-2 diabetes newly starting oral antidiabetic medication. A total of 1,527 African-American patients newly starting antidiabetic medication between July 2001 and June 2002 were compared with 1,128 white patients and 514 patients of other race. Medication adherence was measured as medication possession ratio using prescription refill patterns. Multivariate regression analyses were used to determine the difference in adherence rates adjusting for other covariates.

RESULTS

Medication adherence rate was significantly higher for whites [0.59 (0.31)] as compared to African Americans [0.54 (0.31), (p<0.05)]. In multivariate analyses, the adherence rate of African-American patients was found to be significantly lower by 12% as compared to whites after adjusting for other covariates. Metformin users were associated with a 62% decrease in adherence rate as compared with the sulfonylureas group (p<0.05).

CONCLUSION

The antidiabetic medication adherence was associated with race. Future research should investigate patient-related factors affecting medication adherence in type-2 diabetes patients.

摘要

目的

先前对2型糖尿病患者中药物依从性与种族之间的关联研究不足。本研究的目的是确定2型糖尿病患者中种族与药物依从性之间的关联。

方法

这是一项回顾性队列研究,比较了新开始口服抗糖尿病药物的不同种族的医疗补助参保2型糖尿病患者的药物依从性。将2001年7月至2002年6月期间新开始抗糖尿病药物治疗的1527名非裔美国患者与1128名白人患者和514名其他种族患者进行比较。使用处方 refill 模式将药物依从性测量为药物持有率。采用多变量回归分析来确定在调整其他协变量后依从率的差异。

结果

与非裔美国人[0.54(0.31)]相比,白人的药物依从率[0.59(0.31)]显著更高(p<0.05)。在多变量分析中,调整其他协变量后发现非裔美国患者的依从率比白人显著低12%。与磺脲类药物组相比,二甲双胍使用者的依从率降低了62%(p<0.05)。

结论

抗糖尿病药物依从性与种族有关。未来的研究应调查影响2型糖尿病患者药物依从性的患者相关因素。

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