Skip to main content
SpringerLink
Log in

A ‘Real-World’ Analysis of Persistence on and Adherence to Glipizide GITS, Glipizide IR and Glibenclamide in Managed Care among Patients with Type 2 Diabetes Mellitus

  • Original Research Article
  • Published:
Clinical Drug Investigation Aims and scope Submit manuscript

Abstract

Objective

This study compared persistence on and adherence to therapy with glipizide gastrointestinal therapeutic system (GITS), glipizide immediate release (IR) and glibenclamide (glyburide) in commercially insured patients newly treated for type 2 diabetes mellitus. The objective of the study was to determine if there were differences in persistence and adherence between the three second-generation sulphonylureas.

Study design

This was a retrospective longitudinal claims data analysis for commercial enrollees in eight independent practice model health plans. Study subjects were 25 years of age or older with a first prescription for a study drug from 1 January 1996 through 31 December 1999. All subjects were newly treated with medication for diabetes mellitus, and were initiated on monotherapy. To be included in the study, subjects had to be continuously enrolled in their health plan 6 months prior to their index claim and at least 30 days following the index claim.

Methods and subjects

Persistence was defined as the total days from the index prescription fill date until termination, switch or augmentation of therapy. Adherence was defined as the ratio of days supplied to total days in the treatment period. The treatment period for the measurement of adherence was defined as the period from index prescription fill date to run-out of days supplied of the last filled prescription for the index drug. Cox proportional hazards analysis was used to compare differences in persistence, and multivariate regression was used to assess differences in adherence.

Of the 24 311 subjects, 35% filled a first prescription for glipizide GITS, 15% for glipizide IR, and 50% for glibenclamide. Over one-half of study subjects were male, and the average age was between 51 years for the glipizide GITS cohort and 53 years for the glibenclamide cohort.

Main outcomes and results

By the end of the study, 79% of subjects had terminated therapy with their index drug. Cox proportional hazards analysis showed that patients taking glipizide IR were 1.33 times more likely to experience treatment change [95% confidence interval (CI) 1.25 to 1.42], and patients taking glibenclamide were 1.16 times more likely to change therapy (95% CI 1.11 to 1.22) compared with patients taking glipizide GITS in the first 90 days following initiation of therapy. Similar results were found upon subsequent analysis in the 1620 days following the index prescription. The analysis of adherence showed that patients taking glipizide IR or glibenclamide were less adherent to therapy compared with patients taking glipizide GITS (p < 0.001).

Conclusions

Glipizide GITS appears to have an advantage in persistence on and adherence to therapy compared with glipizide IR and glibenclamide. These differences may be related to administration frequency. Lack of persistence and adherence has potential clinical and economic consequences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Fig. 1
Table II
Table III

Similar content being viewed by others

References

  1. Boyle JP, Honeycutt AA, Narayan KMV, et al. Projection of diabetes burden through 2050. Diabetes Care 2001; 24: 1936–40

    Article  PubMed  CAS  Google Scholar 

  2. American Diabetes Association. Economic consequences of diabetes mellitus in the US in 1997. Diabetes Care 1998; 21: 296–309

    Article  Google Scholar 

  3. National Diabetes Data Group. Diabetes in America. 2nd ed. Washington (DC): US Govt Printing Office, 1995. Report No.: NIH publ. no. 95-1468

    Google Scholar 

  4. UK Prospective Diabetes Study Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53

    Article  Google Scholar 

  5. UK Prospective Diabetes Study Group. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes: prospective observational study (UKPDS 35). BMJ 2000; 321: 405–12

    Article  Google Scholar 

  6. Fertig BJ, Simmons DA, Martin DB. Therapy for diabetes. In: National Diabetes Data Group, editors. Diabetes in America. 2nd ed. Washington (DC): US Govt Printing Office, 1995. Report No.: NIH publ. no. 95-1468

  7. Stata Reference Manual, Release 7, Volume 3 Q-St. College Station (TX): Stata Press, 2001

  8. Rizzo JA, Simons WR. Variations in compliance among hypertensive patients by drug class: implications for health care costs. Clin Ther 1997; 19: 1446–57

    Article  PubMed  CAS  Google Scholar 

  9. White TJ, Chang EY, Vanderplas AM. Impact of compliance on health care cost and utilization in patients with diabetes mellitus and cardiovascular disease [abstract]. 36th ASHP Midyear Clinical Meeting; 2001 Dec 2–6; New Orleans. American Society of Health — System Pharmacists, Bethesda, MD, 2001: PPR–7

    Google Scholar 

  10. Eisen SA, Miller DK, Woodward RS, et al. The effect of prescribed daily dose frequency on patient medication compliance. Arch Intern Med 1990; 140: 1881–4

    Article  Google Scholar 

  11. Paes AH, Bakker A, Soe-Agnie CJ. Impact of dosage frequency on patient compliance. Diabetes Care 1997; 20: 1512–7

    Article  PubMed  CAS  Google Scholar 

  12. Drug Facts and Comparisons. St. Louis (MO): Facts and Comparisons, 2001

  13. Berelowitz M, Fischette C, Cefalu W, et al. Comparative efficacy of a once-daily controlled release formulation of glipizide and immediate release glipizide in patients with NIDDM. Diabetes Care 1994; 17: 1460–4

    Article  PubMed  CAS  Google Scholar 

  14. Simonson DC, Kourides IA, Feinglos M, et al. Efficacy, safety, and dose-response characteristics of glipizide gastrointestinal therapeutic system on glycemic control and insulin secretion in NIDDM: results of two multicenter, randomized, placebo-controlled clinical trials. Diabetes Care 1997; 20: 597-606

    Google Scholar 

  15. Diehl AK, Bauer RL, Sugarek NJ. Correlates of medication compliance in non-insulin-dependent diabetes mellitus. South Med J 1987; 80: 332–5

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

Funding for this study was provided by Pfizer, Inc.

Author information

Authors and Affiliations

  1. Ingenix Inc., 12125 Technology Drive, MN002-0258, Eden Prairie, Minnesota, 55344, USA

    Carolyn R. Hurley, Michael Nelson & Alexander M. Walker

  2. Pfizer Inc., New York, USA

    Avanish Mishra & Scott E. Cantor

Authors
  1. Carolyn R. Hurley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Avanish Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Scott E. Cantor
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alexander M. Walker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carolyn R. Hurley.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hurley, C.R., Mishra, A., Cantor, S.E. et al. A ‘Real-World’ Analysis of Persistence on and Adherence to Glipizide GITS, Glipizide IR and Glibenclamide in Managed Care among Patients with Type 2 Diabetes Mellitus. Clin. Drug Investig. 22, 575–584 (2002). https://doi.org/10.2165/00044011-200222090-00002

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00044011-200222090-00002

Keywords

Search

Navigation