Meds, Clinic Noncompliance Linked to Mortality in Diabetes

Medication, clinic appointment noncompliance ups mortality in insulin-treated type 2 diabetes

TUESDAY, April 24 (HealthDay News) -- Insulin-treated patients with type 2 diabetes who are noncompliant with their medication or clinic appointments face increased all-cause mortality, according to a study published online April 17 in Diabetes Care.

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 nonattenders were more likely to be smokers, younger, have higher glycated hemoglobin, and have more prior primary care contacts and significantly greater morbidity. Medication noncompliers 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.

Several authors disclosed financial ties to medical device and pharmaceutical companies, including Novo Nordisk, which funded this study.

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