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Noncompliance Linked to Mortality in Diabetes

Posted: Tuesday, May 01, 2012

Insulin-treated patients with type 2 diabetes who are noncompliant with their medication or clinic appointments face increased all-cause mortality.

Craig J. Currie, Ph.D., of Cardiff University in the United Kingdom, and colleagues extracted data from the medical records of 15,984 patients with type 2 diabetes who were treated with insulin and had received a prescription for an oral antidiabetic agent. Records were assessed for medication noncompliance (not taking medications as prescribed) or medical appointment nonattendance (missing more than one scheduled visit).

The researchers found that clinic non-attenders were more likely to be smokers, younger, have higher glycated hemoglobin, and have more prior primary care contacts and significantly greater morbidity. Medication non-compliers were more likely to have higher glycated hemoglobin and more prior primary care contacts; they were also significantly more likely to be women, smokers, and have greater morbidity. After adjusting for confounding variables, medication noncompliance, missing one or two clinic appointments, and missing more than two appointments were independent risk factors for all-cause mortality (hazard ratios, 1.579, 1.163, and 1.605, respectively).

"Medication noncompliance and clinic nonattendance, assessed during routine care by primary care physicians or their staff, were independently associated with increased all-cause mortality in patients with type 2 diabetes receiving insulin," the authors write.

Source: http://www.diabetesincontrol.com/index.php?option=com_content&view=article&id=12715&catid=53&Itemid=8, Published online April 17 in Diabetes Care.