Zhou Fang Liz, Yeaw Jason, Karkare Swapna U, DeKoven Mitch, Berhanu Paulos, Reid Timothy
Sanofi US, Bridgewater, New Jersey, USA.
IQVIA, Fairfax, Virginia, USA.
BMJ Open Diabetes Res Care. 2018 Dec 22;6(1):e000593. doi: 10.1136/bmjdrc-2018-000593. eCollection 2018.
Treatment adherence and persistence are essential to achieving therapeutic goals in diabetes and may be improved by patient support programs (PSPs). The COACH Program was launched in 2015 with the goal of supporting patients with diabetes who are prescribed insulin glargine 300 U/mL (Gla-300). The study objective was to assess the program's impact on persistence and adherence with therapy among patients with type 2 diabetes.
A retrospective 12-month analysis was conducted to compare treatment adherence and persistence in patients treated with Gla-300 who actively participated in the COACH PSP versus those who did not enroll using COACH engagement and claims data for the identification period from February 1, 2016 to July 31, 2016. COACH (n=544) and non-COACH (n=544) participants were matched on selected baseline characteristics.
COACH participants were more likely to be adherent to (68.0% vs 61.4%, p= 0.0201; OR: 1.81, p=0.0002) and persistent (48.5% vs 42.1%, p= 0.0309; discontinuation HR: 0.60, p<0.0001) with Gla-300 than non-COACH patients during the 12-month follow-up after controlling for clinical confounders. Additionally, both insulin-naive and basal insulin switcher COACH participants, respectively, were more likely to be adherent (OR: 2.25, p=0.0082 and OR: 1.662, p=0.0364) and persistent (discontinuation HR: 0.53, p=0.0054 and HR: 0.67, p=0.0492) than non-COACH patients. Finally, COACH participants with greater level of engagement showed better persistence.
These data demonstrate that participation and engagement with COACH PSPs are associated with improved persistence and adherence to Gla-300 among patients with type 2 diabetes.
治疗依从性和持续性对于实现糖尿病治疗目标至关重要，患者支持计划（PSP）可能会改善这些情况。COACH计划于2015年启动，旨在为处方甘精胰岛素300 U/mL（Gla-300）的糖尿病患者提供支持。本研究的目的是评估该计划对2型糖尿病患者治疗持续性和依从性的影响。
进行了一项为期12个月的回顾性分析，以比较积极参与COACH PSP的接受Gla-300治疗的患者与未参加COACH的患者的治疗依从性和持续性，使用2016年2月1日至2016年7月31日识别期内的COACH参与情况和理赔数据。COACH组（n = 544）和非COACH组（n = 544）参与者在选定的基线特征上进行匹配。
在控制临床混杂因素后的12个月随访期间，COACH参与者比非COACH患者更有可能坚持使用Gla-300（68.0%对61.4%，p = 0.0201；OR：1.81，p = 0.0002）且持续使用（48.5%对42.1%，p = 0.0309；停药HR：0.60，p < 0.0001）。此外，初治胰岛素患者和基础胰岛素转换者COACH参与者分别比非COACH患者更有可能坚持使用（OR：2.25，p = 0.0082和OR：1.662，p = 0.0364）且持续使用（停药HR：0.53，p = 0.0054和HR：0.67，p = 0.0492）。最后，参与度较高的COACH参与者表现出更好的持续性。
这些数据表明，参与COACH PSP与2型糖尿病患者对Gla-300的持续性和依从性改善相关。
