ORIGINAL RESEARCH
Yu-Chyn Chiang, PharmD; William Ni, PharmD; Guanghao Zhang, MS; Xu Shi, PhD; Minal R. Patel, PhD, MPH
Corresponding Author: Minal R. Patel, PhD, MPH; University of Michigan School of Public Health.
Email: minalrp@umich.edu
DOI: 10.3122/jabfm.2022.220272R2
Keywords: Cross-Sectional Studies, Diabetes Mellitus, Outcomes Assessment, Treatment Adherence
Dates: Submitted: 08-08-2022; Revised: 10-01-2022; 10-05-2022; Accepted: 10-11-2022
Final Publication: | HTML | | PDF |
BACKGROUND: We examined the impact of various comorbid conditions on diabetes and condition-specific cost-related non-adherence (CRN), and HbA1c in adults with diabetes.
METHODS: This was a cross-sectional analysis of participants with diabetes and poor glycemic control in an ongoing trial (n=600). We computed prevalence of condition-specific CRN, prevalence of specific types of diabetes-related CRN by comorbid condition, prevalence of specific types of condition-specific CRN within each comorbidity, and the association between condition-specific and diabetes-related CRN and HbA1c for each comorbid condition.
RESULTS: Fifty-eight percent (n=350) of participants reported diabetes-related CRN. Diabetes-related CRN rates were highest in those with liver problems (63%), anemia (61%), respiratory diseases (60%), and hyperlipidemia (60%). Condition-specific CRN rates were high in those with respiratory diseases (44%), back pain (41%), and depression (40%). Participants with cancer and kidney diseases reported the lowest rates of diabetes-related and condition-specific CRN. Delaying getting diabetes prescriptions filled was the most commonly reported form of diabetes-related CRN across all comorbid conditions and was the highest in those with liver problems (47%), anemia (46%), and respiratory diseases (45%). In adjusted models, those with back pain (0.45; 95%CI 0.02-0.88; p=0.04) and hyperlipidemia (0.50; 95%CI 0.11-0.88; p=0.01) who reported both diabetes-related and condition-specific CRN had higher HbA1c.
CONCLUSIONS: Diabetes-related and condition-specific CRN are commonly experienced by individuals with various comorbid conditions, and is associated with poor disease control. There is an increasing need for providers to screen patients for CRN, especially in those with multiple comorbid conditions, to better address economic burden that may have adverse consequences on health outcomes.