Challenge

Medication non-adherence is a global problem that reduces the efficacy of therapies and speeds up disease progression. That’s especially true in type 2 diabetes.

Our client wanted to understand whether medication non-adherence is associated with glycated hemoglobin (HbA1c) and other non-clinical health outcomes among type 2 diabetes patients using basal insulin analogs. The company aimed to demonstrate whether a simple, patient-reported non-adherence measure could prove to be effective in predicting blood sugar levels and other outcomes. This would help to convince healthcare providers to intervene and administer the measure in the clinic to improve patient outcomes, as well as support better utilization of the company’s products. The company engaged Cerner Enviza because of its expertise in adherence and patient-reported outcomes research.

Approach

Using Cerner Enviza's industry leading National Health and Wellness Survey (NHWS) data, we implemented a study to investigate the relationship between medication adherence and both clinical (HbA1c) and non-clinical (i.e., health status, work impairment and healthcare resource use) health outcomes among type 2 diabetes patients using basal insulin. The NHWS data was ideal for this examination because, in addition to several validated and well-established patient-reported measures of quality-of-life and productivity impairment, plus medication adherence measures, the NHWS features patient-reported assessments of clinical measures such as HbA1c.

Insight

Our study provided strong evidence that medication adherence rates are high among patients with type 2 diabetes using basal insulin. Further, the results suggest that non-adherence has a significant association with HbA1c, and that HbA1c increases concomitantly with non-adherence, as do poorer health status and healthcare resource use.

Impact

This evidence can be used to inform and motivate physicians to assess levels of non-adherence among their patients and to intervene early to help their patients stay on appropriate therapies and keep their disease under control.