Visual Abstract
We investigated the impact of medication adherence for a one-year period and subsequent glycemic control and their combinations on the risk of micro/macrovascular diseases among Japanese using nationwide claims data. Analyzed were 19,565 patients with diabetes whose medication records for oral hypoglycemic agents (OHAs) were available for at least 1 year without prior treatment-requiring diabetic eye disease (TRDED), initiation of dialysis (dialysis), coronary artery disease (CAD), or cerebrovascular disease (CVD), respectively (mean age 53y, HbA1c 7.2%). Medication adherence was evaluated by the proportion of days covered (PDC), and PDC<0.8 was considered to have poor adherence. In each group, the percentage of poor adherence was approximately 30%. Cox regression revealed that poor adherence was an independent risk factor for dialysis. When participants were divided into four groups according to PDC and HbA1c, the risks of TRDED, dialysis, and CAD in the poor adherence/poor glycemic control group were significantly higher compared with the good adherence/good glycemic control group (Table). The risk of micro/macrovascular disease varied according to medication adherence and subsequent glycemic control, suggesting that clinicians should determine treatment strategies considering medication adherence and glycemic control separately.
Y. Yaguchi: None. H. Sone: Research Support; Self; Astellas Pharma Inc., Eisai Co., Ltd., Kyowa Kirin Co., Ltd., Novo Nordisk, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co. K. Fujihara: None. M. H. Yamada: None. Y. Matsubayashi: None. T. Yamada: None. M. Iwanaga: None. M. Kitazawa: None. M. Yamamoto: None. S. Kodama: None.