Irish Journal of Medical Science (1971 -)

, Volume 184, Issue 2, pp 403–410 | Cite as

Regional variation in medication-taking behaviour of new users of oral anti-hyperglycaemic therapy in Ireland

Original Article
First Online:
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Accepted:

Abstract

Background

Few studies have investigated regional variation in medication-taking behaviour. The purpose of this study was to investigate whether there are regional differences in non-persistence and non-adherence to oral anti-hyperglycaemic agents in patients initiating therapy and examine if any association exists between different types of comorbidity in terms of medication-taking behaviour.

Methods

The Irish Health Services Executive (HSE) pharmacy claims database was used to identify new users of metformin or sulphonylureas, aged ≥25 years, initiating therapy between June 2009 and December 2010. Non-persistence and non-adherence were examined up to 12 months post-initiation. Comorbidity was assessed using modified RxRisk and RxRisk-V indices, and classified as either concordant and/or discordant with diabetes. Adjusted hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) for non-persistence were determined in relation to both HSE region and comorbidity type using Cox proportional hazards model, adjusting for age, sex and initial OAH prescribed. Logistic regression analysis, adjusting for these covariates, was used to determine the adjusted odds ratios (ORs) and 95 % CIs for non-adherence for both HSE region and comorbidity type.

Results

Results showed little overall difference between regions. The largest reduction for both non-persistence (HR 0.86, 95 % CI 0.80, 0.94) and non-adherence (OR 0.83, 95 % CI 0.74, 0.93) was observed in the south. Any comorbidity was associated with a reduced risk of non-persistence and non-adherence.

Conclusions

Interventions to optimise medication-taking in patients with T2DM should be implemented nationally to improve the overall level of adherence and persistence, especially in patients with no comorbidity.

Keywords

Type 2 diabetes mellitus Comorbidity Persistence Adherence Oral anti-hyperglycaemic agents Ireland Regional variation 
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Notes

Acknowledgments

Health Service Executive-Primary Care Reimbursement Service for providing the data upon which this study was based and European Commission FP7 funding (2007–2013) Grant No: 223075. This work was conducted as part of the Health Research Board (HRB) Scholars Programme in Health Services Research Grant No: PHD/2007/16.

Conflict of interest

None.

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Copyright information

© Royal Academy of Medicine in Ireland 2014

Authors and Affiliations

  1. 1.Department of Pharmacology and TherapeuticsTrinity Centre for Health Science, St James’s HospitalDublin 8Ireland

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