• Fernie J A Penning-van Beest, Sjoukje van der Bij, Joëlle A Erkens, Sophia Kessabi, Martijn Groot, and Ron M C Herings.
• PHARMO Institute, Utrecht, The Netherlands. fernie.penning@pharmo.nl
• Curr Med Res Opin. 2008 Sep 1; 24 (9): 252325292523-9.

ObjectivesThe aim of this study was to quantify the effect of non-persistence with oral glucose-lowering drugs (OGLD) on HbA(1c) goal attainment (<7%) in daily practice.MethodsFrom the PHARMO Record Linkage System comprising among others linked drug dispensing and clinical laboratory data from approximately 2.5 million individuals in the Netherlands, new users of OGLD in the period 1999-2004 were identified. Patients with a baseline HbA(1c) > or =7% and at least one HbA(1c) measurement in the period of 6-12 months after treatment onset were included in the study cohort. Persistence with OGLD in the first year of treatment was determined using the method of Catalan. In case the first treatment episode overlapped the first HbA(1c) measurement within 6-12 months after treatment onset, a patient was considered persistent at that measurement. Patients with a HbA(1c) <7% were defined as having attained goal.ResultsThe study cohort included 2023 patients with a mean baseline HbA(1c) of 8.9 +/- 1.8%. Three-quarters (1512 patients) were persistent with any OGLD at the first HbA(1c) measurement within 6-12 months after treatment onset; of these, 861 (57%) were at goal. Of the 511 non-persistent patients, 239 (47%) were at goal. Non-persistent patients were about 20% less likely to attain goal (RRadj 0.82; 95%CI 0.74-0.91), compared to persistent OGLD users.ConclusionNon-persistent use of OGLD leads to a 20% decreased probability of HbA(1c) goal attainment in daily practice. This effect of non-persistence seems modest, but represents around 12 000 new and 10 000 prevalent OGLD users a year in the Netherlands in whom OGLD use could be better controlled.

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