Lunghi Carlotta, Zongo Arsène, Moisan Jocelyne, Grégoire Jean-Pierre, Guénette Line
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.
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.
J Diabetes Complications. 2017 Jul;31(7):1200-1206. doi: 10.1016/j.jdiacomp.2017.02.016. Epub 2017 Mar 12.
To identify factors associated with antidiabetic drug (AD) non-adherence among patients with type 2 diabetes and depression.
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.
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.
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.
确定2型糖尿病合并抑郁症患者中与抗糖尿病药物（AD）治疗依从性不佳相关的因素。
我们对开始使用AD后被诊断为抑郁症的新AD使用者进行了一项基于人群的回顾性队列研究。我们使用了魁北克的公共医疗保险数据。因变量是抑郁症诊断后一年内的治疗不依从情况（即，≥1种AD覆盖天数<90%）。评估了不同的社会人口学、临床和药物相关变量作为AD治疗不依从的潜在因素。我们进行了单变量和多变量逻辑回归分析。
我们确定了2000年至2006年间3106名新的AD使用者，他们被诊断为抑郁症。在这些个体中，52%被认为对其AD治疗不依从。基线不依从、年龄较小、初始治疗中添加另一种AD、药物报销申请<4次、就诊于多位不同医生、社会经济地位较高以及糖尿病并发症较少与AD治疗不依从相关。
本研究中确定的因素可能有助于临床医生识别2型糖尿病合并新发抑郁症且治疗不依从风险增加的患者。对于这些患者，密切随访和针对性干预可能有助于提高AD治疗的依从性、改善血糖控制并减少并发症。
