Skipping diabetes meds ups risk of hospitalization

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Type 2 diabetic patients who take their oral medications only part of the time have an increased risk of being hospitalized within a one-year period, the results of a new study indicate.

Dr. David P. Nau, along with Dr. Denys T. Lau, of the University of Michigan in Ann Arbor, used claims data from a managed care organization to examine the link between nonadherence to diabetes drugs and subsequent hospitalization in 900 adult type 2 diabetics.

Over a 12-month period, 28.9 percent of patients were nonadherent to the antihyperglycemic regimen, they report in Diabetes Care.

According to the data, the risk of hospitalization in 2001 increased by more than twofold in type 2 diabetics who were nonadherent to their oral diabetes medications the year before.

“It isn’t just the patients who completely stop their medications who are at higher risk of hospitalization,” Nau told Reuters Health, “since the patients in our study who obtained less than 80 percent of their scheduled doses had a hospitalization rate approximately twice that of patients who were nearly perfect in their adherence.”

This increased risk of hospitalization remained strong even after considering the effect of other illnesses and the patients’ adherence to High Blood Pressure and cholesterol-lowering medications.

Nonadherence to High Blood Pressure and cholesterol-lowering medications, seen in 18.8 percent and 26.9 percent of study subjects, respectively, was not significantly associated with an increased risk of hospitalization.

“If strategies can be developed to identify and intervene with [nonadherent] patients, there may be substantial benefits to patients as well as the payers for health care services,” the researchers conclude in their report.

Nau suggests that for some diabetic patients, “referral to a certified diabetes educator might be quite useful.”

SOURCE: Diabetes Care September 2004.

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