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Diabetes Metab. 2013 May;39(3):250-7. doi: 10.1016/j.diabet.2012.12.005. Epub 2013 Mar 21.

Difficulty adhering to antidiabetic treatment: factors associated with persistence and compliance.

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Faculty of Pharmacy, Université Laval, Québec, QC, Canada.



This study aimed to assess the 1-year treatment persistence and compliance of new oral antidiabetic drug (OAD) users with their treatment, and to identify the factors associated with both persistence and compliance.


This population-based cohort study of new OAD users aged 18 years or above used the Quebec health insurance board databases. Those having a prescription filled for antidiabetic treatment during the period leading up to the 1-year anniversary of their first claim were considered to be persistent with their antidiabetic treatment. Of these patients, individuals with a medication possession ratio (MPR) greater or equal to 80% for OAD or insulin were deemed compliant. Also identified were the characteristics associated with both outcomes, using a multivariate logistic regression model.


Our cohort consisted of 151,173 individuals, 119,832 (79.3%) of whom were considered persistent. Of these, 93,418 (78.0%) were also deemed compliant. Persistence and compliance were associated with older ages, living in a rural region, low socioeconomic status, having the first OAD prescribed by a general practitioner and a history of using five different drugs or more. People were less likely to be persistent and compliant if their initial OAD was a secretagogue and if they had consulted a physician eight times or more during the year prior to starting treatment.


One year after OAD treatment initiation, 21% had discontinued their treatment and 22% of those still being treated were non-compliant. These results could help to tailor interventions aimed at optimizing the use of OAD treatments.

[Indexed for MEDLINE]

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