Factors Associated with Secondary Nonadherence to Oral Antihyperglycemic Agents among Patients with T2DM

Glycemic control in patients with T2DM remains sub-optimal. A major contributor to poor goal achievement is medication nonadherence. This study aimed to examine secondary nonadherence to oral anti-hyperglycemic agents (AHA) among T2DM patients and to assess its association with community- and individual-level characteristics. Using claims and electronic medical records in Geisinger Health System during 2003-2015, this retrospective cohort study included adults with newly diagnosed T2DM who filled their 1st order of oral AHA. Secondary nonadherence was determined when patients did not fill the 2nd oral AHA prescription within 30 days after the 1st fill supply ended. Among 2,413 patients who filled the 1st order, 764 (31.7%) were not adherent to the 2nd prescription. Younger age, non-white (vs. white) and chronic kidney disease was associated with higher odds of nonadherence. Patients with higher baseline HbA1c when ≤ 10% was associated with lower odds of nonadherence, while those with higher baseline HbA1c when >10% were more likely to be non-adherent. Community-level characteristics were not found to be associated with nonadherence. Nearly one-third of patients did not complete a 2nd fill of their oral AHA. This study identified patient characteristics associated with secondary nonadherence that may provide intervention points for improving medication adherence in diabetes management. Disclosure S. Larson: None. Y. Tang: Employee; Self; Merck & Co., Inc.. Stock/Shareholder; Self; Merck & Co., Inc.. Employee; Spouse/Partner; GlaxoSmithKline plc.. Stock/Shareholder; Spouse/Partner; GlaxoSmithKline plc.. H. Kirchner: None.