Racial Differences in Diabetes Medication Adherence
Author Information
Author(s): Trinacty Connie M, Adams Alyce S, Soumerai Stephen B, Zhang Fang, Meigs James B, Piette John D, Ross-Degnan Dennis
Primary Institution: Harvard Medical School and Harvard Pilgrim Health Care
Hypothesis
Blacks are hypothesized to be consistently less adherent to prescribed regimens than whites over time.
Conclusion
Racial differences in adherence to oral antidiabetic drug therapy persist even with equal access to medication.
Supporting Evidence
- Black patients were as likely as whites to initiate oral therapy and fill their first prescription.
- Black patients experienced higher rates of medication discontinuation and were less adherent over time.
- Significant black-white differences in adherence levels were constant throughout follow-up for patients initiated on metformin therapy.
Takeaway
This study found that black diabetes patients often stop taking their medications sooner than white patients, even when they have the same access to those medications.
Methodology
A longitudinal retrospective cohort study using 10 years of patient-level claims and electronic medical record data.
Potential Biases
Potential over-control of race-related barriers may underestimate the impact of race on adherence.
Limitations
Race was determined from clinician reports, which may lead to misclassification, and the study is limited to a single multi-specialty care group.
Participant Demographics
26% black and 74% white, with black patients being more likely to be female and younger.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI: 1.2, 2.7
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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