Objectives: Treatment adherence and persistence lead to gaps in achieving glycemic control in type 2 diabetes (T2D). We sought to identify predictors of adherence and persistence to basal insulin therapy among adults with T2D initiating therapy.
Methods: Commercially insured US adults with T2D initiating basal insulin treatment between January 1, 2016 and December 31, 2018 were identified using IQVIA PharMetrics® Plus claims data. Adherence and persistence were quantified based on basal insulin claims in the one-year follow-up period and established definitions. Logistic regression models were developed to identify predictors of adherence and persistence based on baseline clinical and demographic information.
Results: Among the 64,953 patients sampled, medication adherence and nonadherence (42% and 58%) and medication persistence and non-persistence (57% and 43%) were identified. Older age at baseline, oral and injectable antidiabetic medicine use, and physician office visits were associated with increased persistence and adherence; baseline hospitalization and emergency room visits were associated with decreased levels.
Conclusions: Multiple predictors of adherence and persistence with basal insulin therapy were identified. These findings may help guide therapeutic choices and research priorities to bridge the gap between achievable efficacy of insulin therapy and real-world effectiveness.
V.R.Aroda: Consultant; Applied Therapeutics Inc., Fractyl Health, Inc., Novo Nordisk, Pfizer Inc., Sanofi, Other Relationship; Janssen Pharmaceuticals, Inc., Research Support; Applied Therapeutics Inc., Eli Lilly and Company, Fractyl Health, Inc., Novo Nordisk, Sanofi. N.F.Nielsen: Employee; Novo Nordisk A/S, Coloplast A/S. K.K.Mangla: Employee; Novo Nordisk A/S, Stock/Shareholder; Novo Nordisk A/S. Y.Wang: None. T.Namvar: None. J.R.Rajpura: Employee; Novo Nordisk.
