This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (16)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal

Vanessa S. Catalan, PhD; Julie A. Couture, MD; Jacques LeLorier, MD, PhD

Arch Intern Med. 2001;161:1106-1112.

Background  A carbose is the first of a new class of antidiabetic agents, the -glucosidase inhibitors.This study characterizes and identifies predictors of persistence of use of acarbose.

Methods  Medical, pharmaceutical, and demographic records were extracted for 2 cohorts of patients (social assistance recipients and seniors) from the databases of Quebec's provincial health plan. Patients were eligible for inclusion if they had received their first dispensation of acarbose between August 1, 1996, and December 31, 1997. The observation period included at least 1 year before the first dispensation and a minimum of 4 months after.

Results  New users of acarbose included 216 social assistance recipients and 677 seniors who were followed up for 82 914 and 270 041 person-days, respectively. Median persistence with acarbose treatment was 83 days (95% confidence interval, 75-105 days) for social assistance recipients and 105 days (95% confidence interval, 90-119 days) for seniors. In both cohorts, treatment by an endocrinologist vs another physician predicted longer treatment persistence. In the seniors cohort, additional determinants of (earlier) treatment discontinuation included a higher initial daily dose, previous treatment with insulin, and consultation with a gastroenterologist after treatment initiation.

Conclusions  New users of acarbose showed low persistence in 2 cohorts of beneficiaries of Quebec's provincial health plan. Prescribing specialist was an important predictor of persistence in seniors and the socially assisted. The importance of 4 additional factors in seniors only led to hypotheses concerning population differences in treatment expectations and in the occurrence and tolerance of adverse effects.

From the Pharmaco-Epidemiology and Pharmaco-Economics Research Unit, Hôtel-Dieu de Centre Hospitalier de l'Université de Montréal, Montreal (Drs Catalan and LeLorier), and Hôtel-Dieu de Lévis, Centre Hospitalier affilié a l'Université Laval, Quebec (Dr Couture), Quebec.

RELATED ARTICLE

Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2001;161(8):1120-1121.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Do patients' expectations influence their use of medications?: Qualitative study
Dolovich et al.
cfp 2008;54:384-393.
ABSTRACT | FULL TEXT  

Restrictive access to clopidogrel and mortality following coronary stent implantation
Sheehy et al.
CMAJ 2008;178:413-420.
ABSTRACT | FULL TEXT  

Medication Taking and Diabetes: A Systematic Review of the Literature
Odegard and Capoccia
The Diabetes Educator 2007;33:1014-1029.
ABSTRACT | FULL TEXT  

Effectiveness of Interventions by Community Pharmacists to Improve Patient Adherence to Chronic Medication: A Systematic Review
Van Wijk et al.
The Annals of Pharmacotherapy 2005;39:319-328.
ABSTRACT | FULL TEXT  

A Systematic Review of Adherence With Medications for Diabetes
Cramer
Diabetes Care 2004;27:1218-1224.
ABSTRACT | FULL TEXT