OBJECTIVE: The impact of taking oral @entity413 -lowering medicines intermittently, rather than as recommended, is unclear. We conducted a retrospective cohort study using community-acquired U.K. clinical data (Clinical Practice Research Database [CPRD] and GoDARTS database) to examine the prevalence of nonadherence to treatment for @entity164 2 @entity6 and investigate its potential impact on HbA1c reduction stratified by @entity164 of @entity413 -lowering medication. RESEARCH DESIGN AND METHODS: Data were extracted for @entity1 treated between 2004 and 2014 who were newly-prescribed @entity2449 , @entity5736 , @entity12585 , or @entity5735 inhibitors and who continued to obtain prescriptions over 1 year. Cohorts were defined by prescribed medication @entity164 , and good adherence was defined as a medication possession ratio >= 0.8. Linear regression was used to determine potential associations between adherence and 1-year baseline-adjusted @entity4051 c reduction. RESULTS: In CPRD and GoDARTS, 13% and 15% of @entity1 , respectively, were nonadherent. Proportions of nonadherent @entity1 varied by the oral @entity413 -lowering treatment prescribed (range 8.6% [ @entity12585 ] to 18.8% [ @entity2449 ]). Nonadherent, compared with adherent, @entity1 had a smaller HbA1c reduction (0.4% [4.4mmmol/mol] and 0.46% [5.0 mmol/mol] for CPRD and GoDARTs, respectively). Difference in HbA1c response for adherent compared with nonadherent @entity1 varied by drug (range 0.38% [4.1 mmol/mol] to 0.75% [8.2 mmol/mol] lower in adherent group). Decreasing levels of adherence were consistently associated with a smaller reduction in HbA1c. CONCLUSIONS: Reduced medication adherence for commonly used @entity413 -lowering therapies among @entity1 persisting with treatment is associated with smaller HbA1c reductions compared with those taking treatment as recommended. Differences observed in HbA1c responses to @entity413 -lowering treatments may be explained in part by their intermittent use.

Adherence to Oral XXXX -Lowering Therapies and Associations With 1-Year HbA1c: A Retrospective Cohort Analysis in a Large Primary Care Database.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity4051 :: ('3039', 'Gene') :: ['HbA1'] @entity5735 :: ('1803', 'Gene') :: ['dipeptidyl peptidase-4'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity12585 :: ('MESH:C089946', 'Chemical') :: ['thiazolidinedione'] @entity5736 :: ('D013453', 'Chemical') :: ['sulfonylurea'] @entity164 :: ('MESH:D017827', 'Disease') :: ['type'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose'] @entity2449 :: ('MESH:D008687', 'Chemical') :: ['metformin']
@entity413 :: (MESH:D005947,Chemical) :: ['Glucose']
