663-P: Medication Adherence (MA) Is an Independent Predictor for Glycemic Control Even after Adjustment for Lifestyle Confounders in Japanese Patients with Type 2 Diabetes

The impact of MA on glycemic control may be affected by lifestyle confounders but little is known on this topic. We investigated clinical variables significantly associated with MA for OHA and the association between MA and glycemic control considering the effects of smoking, drinking alcohol, exercise and dietary habits in Japanese with DM using a large claims database. Analyzed were 6651 DM patients with medication records for OHA for at least 1 y (mean age 54 y, HbA1c 7.2%). MA was evaluated by the proportion of days covered (PDC), and PDC <80% was defined as non-adherence. Mean PDC was 80.7% and 31.8% of patients were non-adherent. Logistic analysis indicated that older age and taking ≥2 concomitant medications were significantly associated with adherence (odds ratio (OR) 1.34 (95% CI 1.24-1.44) and 1.19 (1.01-1.40), respectively) while smoking and skipping breakfast were significantly associated with non-adherence (OR 0.88 (0.78-0.99) and 0.60 (0.51-0.71), respectively). Multiple regression analysis showed that PDC was negatively correlated with HbA1c after adjusting for lifestyle factors. HbA1c decreased by 0.2% with a 25% increase in PDC. MA was significantly associated with glycemic control even after adjustment for lifestyle factors, suggesting the importance of improving MA in parallel with lifestyle education.