Abstract

Objective: We evaluate ethnic differences in medication concerns (e.g., side effects, costs) that may contribute to ethnic differences in the adoption of and adherence to type 2 diabetes treatments.

Research Design and Methods: We conducted face-to-face interviews from 5/04-5/06 with patients, ≥18 years of age, living with type 2 diabetes (N=676, 25% Latino (L), 34% non-Hispanic White (W), and 41% non-Hispanic African American (AA)) attending Chicago-area clinics. Primary outcomes of interest were concerns regarding medications and willingness to take additional medications.

Results: Latinos and African Americans had higher glycosylated hemoglobin levels than Whites (HbA_1C 7.69 (L), 7.54 (AA), and 7.18 (W), p<0.01). Latinos and African Americans were more likely than Whites to worry about drug side effects (66% (L), 49% (AA), and 39% (W)) and medication dependency (65% (L), 52% (AA), and 39% (W))(p's<0.01). Ethnic minorities also were more likely to report a reluctance to adding medications to their regimen (18% (AA), 12% (L), 7% (W), p<0.01). In analyses adjusted for demographics, income, education, and diabetes duration, current report of pain/discomfort with pills (OR 2.43, 95% CI (1.39, 4.27)), concern regarding disruption of daily routine (OR 1.97, 95%CI (1.14, 3.42)) and African American ethnicity (OR 2.48, 95% CI (1.32, 4.69) emerged as major predictors of expressed reluctance to adding medications.

Conclusions: Latinos and African Americans had significantly more concerns regarding the quality of life effects of diabetes-related medications than Whites. Whether these medication concerns contribute significantly to differences in treatment adoption and disparities in care deserves further exploration.