Treatment Non-compliance and Mortality in Patients with Type 1 Diabetes

Senior man with glasses in hand looks thoughtfully at many pills on table in front of himThe extent to which patients are compliant with their type 1 diabetes treatment may have an effect on their all-cause mortality risk, according to the results of a study.

Researchers at Cardiff University in the United Kingdom recently explored the effects of non-compliance (both medication non-compliance, and not showing up for scheduled medical appointments) on all-cause mortality rates in people living with type 1 diabetes.

Their study, “The impact of treatment non-compliance on mortality in people with type 1 diabetes,” was published online ahead of print in November 2012. It appears in the Journal of Diabetes and its Complications.

The researchers relied on data from The Health Improvement Network (THIN) database which contains information on patients seen at more than 350 facilities in the United Kingdom. Only participants who had diagnostic codes that indicated type 1 diabetes were included in the study. Treatment non-compliance was defined as missing medications or missing one or more scheduled medical appointments.

The results of the study showed that 29.4% of the patients included in the study (867 out of 2,946) were non-compliant in their medication regimen, or missed medical appointments during the 30-month assessment period. After controlling for confounding factors, the researchers found that patients who were not compliant with their treatment had a mortality rate of 1.462 (95% CI 0.954-2.205), and that treatment non-compliance was linked to a heightened risk of all-cause mortality in these patients.

The researchers conclude that their findings demonstrate an association between all-cause mortality and treatment non-compliance (both medication non-compliance and missing scheduled medical visits) in patients with type 1 diabetes. They argue that more efforts should be made to understand the reasons why patients are not compliant with their medications and treatment, and to help develop strategies to increase the life expectancy of people living with type 1 diabetes.

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