Predictors of statin adherence in Medicaid patients with type 2 diabetes and comorbid hyperlipidemia
J. Wu1, E. Seiber2, V.A. Lacombe3, M.C. Nahata3, and R. Balkrishnan4,5,6
1Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, Greenville, South Carolina, 2Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, 3Division of Pharmacy Practice and Administration, College of Pharmacy, The Ohio State University, Columbus, Ohio, 4Center for Medication Use, Policy, and Economics, University of Michigan, Ann Arbor, Michigan, 5Department of Clinical, Social and Administrative Sciences, University of Michigan, Ann Arbor, Michigan, 6Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan, USA

Abstract

Background and aims: Adherence to statin treatment is important for diabetic patients to prevent coronary heart disease. The study compared statin adherence between diabetic and non-diabetic patients enrolled in Medicaid program and identified predictors of statin adherence in diabetic patients. Methods: This was a retrospective claims-based study. Medicaid patients with type 2 diabetes and hyperlipidemia (study group) started to use statins in 2005 and were followed up for one year. Patients with hyperlipidemia but without diabetes were included as a control group. The data including demographics, medical utilization, clinical related and medication related variables were collected from MarketScan® Medicaid database. Medication adherence was measured by medication possession ratio (MPR). Multiple regression analyses were implemented to compare MPRs and likelihood of statin adherence (MPR≥0.8) between diabetic and non-diabetic patients and to identify predictors of statin adherence in diabetic patients. Results: A total of 7184 eligible patients with hyperlipidemia were included in the study (5479 for non-diabetic group, 1705 for diabetic group). In diabetic patients, the mean MPR was 0.61 and 37% of those patients were adherent to statins for one year. Diabetic patients were 1.6 times more likely to be adherent to statins compared to non-diabetic patients. Age, race, ER visit, and total number of outpatient visits in the baseline year were significant predictors of statin adherence. Conclusions: Statin non-adherence is still a serious problemin diabetic patients enrolled in Medicaid program. Early interventions are needed for high-risk people to improve the use of statins in diabetic patients. Obesity and Metabolism 2010; 6: 111-116.

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