Association Between Depression And Discontinuation With Antidiabetic Drugs

objeCtives: Adherence to antidiabetic treatment is a crucial issue in type 2 diabetes management. Depression negatively influences adherence to self-care recommendations, such as diet, physical activity and drug therapy. The objectives of this study are to measure the association between depression and discontinuation with antidiabetic drugs (ADs), among new users of oral antidiabetic drugs (OADs) and to estimate factors associated with discontinuation among these new users with depression. Methods: We used administrative claims data of the public health insurance plan in Quebec, Canada, to identify an adult cohort (≥ 18 years) of new OAD users free of depression between 2000 and 2006. We followed patients from OAD initiation up to AD discontinuation, ineligibility to the public drug plan, death, or the end of the study, i.e. December 31, 2008, whichever came first. A Cox regression model with depression as a time-dependent variable was used to compute the adjusted hazard ratio (AHR) of discontinuation. A Cox regression models was used to identify factors associated with discontinuation in the sub-cohort of patients with depression. Results: We identified 114,366 new OAD users, of which 4,808 were diagnosed with depression during follow-up. The median time from OAD treatment initiation to discontinuation was 2.4 years: 55.4 % of patients with depression versus 44.5% without depression discontinued their treatment during follow-up. The AHR of discontinuation with ADs was 1.52 (95% confidence interval [CI]: 1.41-1.63). Among the 4,808 patients with depression, independent factors associated with discontinuation included starting treatment with other drugs than metformin (especially polytherapy with insulin), being pre-scribed the first OAD by a specialist (vs a general practitioner), and younger age at OAD initiation (< 45 years). Conclusions: Patients with depression are more likely to discontinue their treatment. Physicians should target patients at risk for discontinuation in order to improve persistence with antidiabetic drugs and diabetes management. (PDF) Association Between Depression And Discontinuation With Antidiabetic Drugs. Available from: https://www.researchgate.net/publication/284007542_Association_Between_Depression_And_Discontinuation_With_Antidiabetic_Drugs [accessed Jan 13 2022].