Medication adherence in young adults with youth-onset type 2 diabetes: iCount, an observational study

Authors

Paula M. Trief, State University of New York (SUNY) Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210, USA. Electronic address: triefp@upstate.edu.
Seth C. Kalichman, University of Connecticut, 2006 Hillside Road, Storrs, CT 06269-1020, USA. Electronic address: seth.k@uconn.edu.
Dongliang Wang, State University of New York (SUNY) Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210, USA. Electronic address: wangd@upstate.edu.
Kimberly L. Drews, George Washington University, 6110 Executive Blvd., Rockville, MD 20852, USA. Electronic address: kdrews@bsc.gwu.edu.
Barbara J. Anderson, Baylor College of Medicine, 1102 Bates Ave., Houston, TX 77030, USA. Electronic address: bja@bcm.edu.
Jane D. Bulger, State University of New York (SUNY) Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210, USA. Electronic address: bulgerj@upstate.edu.
Ruth S. Weinstock, State University of New York (SUNY) Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210, USA. Electronic address: weinstor@upstate.edu.

Document Type

Journal Article

Publication Date

2-1-2022

Journal

Diabetes research and clinical practice

Volume

184

DOI

10.1016/j.diabres.2022.109216

Keywords

Adults; Ethnic differences; Insulin therapy; Oral therapies; Self-management; Type 2 diabetes

Abstract

AIMS: To assess prevalence of, and factors associated with, medication adherence of young adults with youth-onset type 2 diabetes. METHODS: Oral hypoglycaemia agent (OHA) adherence was measured with unannounced telephone pill counts, insulin adherence was self-reported. Those taking ≥ 80% of pills/insulin were classified "high-adherent," <80% of pills/insulin "low-adherent." Analyses included unadjusted, and adjusted linear and logistic regressions assessing associations of participant factors with adherence. RESULTS: For people taking OHAs (N = 212, mean age 26 yrs, 67% women, 18% non-Hispanic White, 35% non-Hispanic Black, 41% Hispanic), 69.8% were low-adherent. HbA1c was lower in the high-adherent group (9.2%/77 mmol/mol vs. 10.0%/86 mmol/mol, p < 0.04). More non-Hispanic Blacks were low-adherent (85.7%) than Hispanics (60.2%) and non-Hispanic whites (55.3%, p < 0.002); 91.4% of participants without healthcare coverage were low-adherent vs. 65.5% of those with coverage (p < 0.004). After adjustment, gender (p = 0.024), race/ethnicity (p < 0.001) and healthcare coverage (p = 0.001) remained related to OHA adherence. For insulin (N = 192), 37% were low-adherent. HbA1c was associated with insulin adherence (low = 11.2%/99 mmol/mol vs. high = 10.0%/86 mmol/mol, p < 0.001) with and without adjustment. CONCLUSIONS: Young adults with youth-onset type 2 diabetes, especially females, non-Hispanic Blacks and those without healthcare coverage, commonly had low-OHA adherence. Glycaemic control was also poor. Interventions to improve medication adherence are needed for this vulnerable group.

APA Citation

Trief, Paula M.; Kalichman, Seth C.; Wang, Dongliang; Drews, Kimberly L.; Anderson, Barbara J.; Bulger, Jane D.; and Weinstock, Ruth S., "Medication adherence in young adults with youth-onset type 2 diabetes: iCount, an observational study" (2022). GW Authored Works. Paper 354.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/354

Department

Biostatistics and Bioinformatics