Medication adherence and use of preventive diabetes services*
| Unadjusted means/proportions | Model-based (adjusted) estimates | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| No major depression | Major depression | Mean difference | Odds ratio | 95% CI | P (n) | |||||
| Nonadherence to medication | ||||||||||
| Oral hypoglycemic | 18.8% | 24.5% | 3.62 | — | 1.18–6.06 | <0.005 | ||||
| Lipid lowering | 19.3% | 27.2% | 6.79 | — | 3.11–10.46 | <0.0005 | ||||
| ACE inhibitors | 21.6% | 27.9% | 5.59 | — | 1.41–9.78 | 0.01 | ||||
| Preventive diabetes services | ||||||||||
| No HbA1c test within the last year | 4.0% | 6.3% | — | 1.9 | 1.27–2.87 | <0.005 (4,347) | ||||
| Fewer than three HbA1c tests per year among patients with HbA1c >8% | 55.1% | 55.5% | — | 0.9 | 0.70–1.21 | NS (1,922) | ||||
| No retinal examination within the last year | 19.4% | 17.2% | — | 1.0 | 0.74–1.24 | NS (4,347) | ||||
| Less than two examinations within 2 years among patients with retinopathy | 24.8% | 22.5% | — | 0.8 | 0.55, 1.31 | NS (1,179) | ||||
| No microalbumin urine test within the last year among patients not taking ACE inhibitors | 47.0% | 45.6% | — | 1.0 | 0.80–1.33 | NS (1,831) | ||||
↵* Nonadherence to medication outcomes are continuous measures of the percentage of nonadherent days for each individual. Preventive diabetes services outcomes are dichotomous, indicating use or no use. Model-based estimates of percentage point difference in adherence and odds ratios with corresponding CIs and P values are adjusted for age, sex, marital status, education, race/ethnicity, medication risk (a pharmacy-based comorbidity measure), diabetes complications, and treatment intensity. Models also adjust for clustering by clinic and physician.