What factors influence concordance with medications? Findings from the UK Asian Diabetes Study.

Lloyd, C. E.; Mughal, S.; Roy, T.; Raymond, N. T.; O'Hare, J. P.; Barnett, A. H. and Bellary, S. (2014). What factors influence concordance with medications? Findings from the UK Asian Diabetes Study. Diabetic Medicine, 31(12) pp. 1600–1609.

DOI: https://doi.org/10.1111/dme.12554


Aims The aims of this study were to investigate levels of concordance with medication taken at baseline assessment and after two years of follow-up and to examine the factors that might be associated with non-concordance in a South Asian population living in the UK.

Methods A secondary data analysis was conducted on a sub-sample of general practices participating in either the intervention or control arm of the cluster randomised controlled trial UK Asian Diabetes study(UKADS), to examine factors associated with non-concordance with medications.

Results Non-concordance was significantly associated with older age, severe anxiety or depression and a higher number of prescribed medications (blood pressure, cholesterol, diabetes medications and other types of medication). Multivariable analyses confirmed that prescription of a higher number of blood pressure (odds ratio (95% confidence interval) 3.74 (2.63 – 5.34)) or diabetes medications 1.77 (1.05 – 3.10) and poor mental health 6.06 (1.57 – 23.47) were independently associated with non-concordance at baseline with baseline concordance 6.55 (2.52 – 17.00) being an additional significant factor at follow-up.

Conclusions Non-concordance with medications is common and more likely in people prescribed more medications for diabetes and its complications. These results are a cause for concern, especially given the current climate of aiming to achieve specified risk factor levels, often by increasing numbers as well as doses of medications. From a health services provision perspective, the high cost of medications and the implications of poor health behaviours on morbidity and mortality as well as health services utilisation are important considerations.

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