Cited by 1,135Medication Adherence and ComplianceDiabetes Management and EducationPatient Safety and Medication Errors

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Effect of Medication Nonadherence on Hospitalization and Mortality Among Patients With Diabetes Mellitus

Ho, P. Michael, Rumsfeld, John S., Masoudi, Frederick A., McClure, David L., Plomondon, Mary E., Steiner, John F., Magid, David J.·2006·Archives of Internal Medicine

DOI 10.1001/archinte.166.17.1836

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Abstract

BACKGROUND: Medication nonadherence may reduce the effectiveness of therapies. To our knowledge, the association between medication nonadherence and mortality remains unexplored outside the context of clinical trials. METHODS: A retrospective cohort study of 11 532 patients with diabetes mellitus in a managed care organization. Medication adherence was calculated as the proportion of days covered for filled prescriptions of oral hypoglycemics, antihypertensives, and statin medications. The primary outcomes of interest were all-cause hospitalization and all-cause mortality. Multivariable regression analyses were performed to assess the independent association between medication adherence and outcomes. RESULTS: Nonadherent patients (proportion of days covered, <80%; prevalence, 21.3%) were younger and had fewer comorbidities compared with adherent patients. During follow-up, nonadherent patients had higher glycosylated hemoglobin, systolic and diastolic blood pressure, and low-density lipoprotein cholesterol levels. In unadjusted analyses, nonadherent patients had higher all-cause hospitalization (23.2% vs 19.2%, P<.001) and higher all-cause mortality (5.9% vs 4.0%, P<.001). In multivariable analyses, medication nonadherence remained significantly associated with increased risks for all-cause hospitalization (odds ratio, 1.58; 95% confidence interval, 1.38-1.81; P<.001) and for all-cause mortality (odds ratio, 1.81; 95% confidence interval, 1.46-2.23; P<.001). The findings were consistent across patient subgroups and using different cutoffs for the proportion of days covered. CONCLUSIONS: Medication nonadherence is prevalent among patients with diabetes mellitus and is associated with adverse outcomes. Interventions are needed to increase medication adherence so that patients can realize the full benefit of prescribed therapies.

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Retracted
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Authors: Ho, P. M., Rumsfeld, J. S., Masoudi, F. A., McClure, D. L., Plomondon, M. E., Steiner, J. F., & Magid, D. J.
Affiliations: Denver VA Medical Center (US)
ORCID: Ho, P. Michael
Masoudi, Frederick A.
McClure, David L.
Plomondon, Mary E.
Steiner, John F.
Magid, David J.
Venue: Archives of Internal Medicine
Publisher: American Medical Association (AMA)
Published: 2006-09-25
Volume: 166
Issue: 17
Pages: 1836
ISSN: 0003-9926 (ISSN-L)
DOI: 10.1001/archinte.166.17.1836
OpenAlex: W2156108549
Cited by: 1,135
References: 34
Citations by year: 2026: 15 · 2025: 38 · 2024: 41 · 2023: 57 · 2022: 49 · 2021: 60 · 2020: 58 · 2019: 63 · 2018: 76 · 2017: 63 · 2016: 81 · 2015: 75 · 2014: 93 · 2013: 60 · 2012: 75
FWCI: 23.54
Type: journal article
Language: en
Open access: closed
Locations: Archives of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Aging (K08-AG01011, K08AG001011)
Topics: Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
Keywords: medication non-adherence, diabetes mellitus, hospitalization, all-cause mortality, proportion of days covered, oral hypoglycemics, antihypertensive drugs, statins, HbA1c, blood pressure, LDL cholesterol, managed care
MeSH terms: Administration, Oral, Aged, Antihypertensive Agents, Blood Pressure, Diabetes Mellitus, Female, Glycated Hemoglobin, Hospitalization, Humans, Hypoglycemic Agents, Cholesterol, LDL, Male, Middle Aged, Mortality, Retrospective Studies, Treatment Refusal, Hydroxymethylglutaryl-CoA Reductase Inhibitors

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Effect of Medication Nonadherence on Hospitalization and Mortality Among Patients With Diabetes Mellitus

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