(74) Persistence and Adherence to Antidiabetic Drugs in Social Health Insurance Participants Attending a Primary Care Clinic in Banjarmasin, Indonesia

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1119

Presenting Author(s)

Alfi Yasmina
– School of Medicine Lambung Mangkurat University, Banjarmasin, Kalimantan Selatan, Indonesia

Co-Author(s)

Farida Heriyani
– Department of Public Health, Faculty of Medicine, Universitas Lambung Mangkurat, Indonesia
Muhammad Arifial Asyum
– Medicine Study Program, Faculty of Medicine, Universitas Lambung Mangkurat, Indonesia
Djallalluddin Djallalluddin
– Department of Internal Medicine, Faculty of Medicine, Universitas Lambung Mangkurat, Indonesia
Hendra Wana Nur’amin
– Department of Pharmacology, Faculty of Medicine, Universitas Lambung Mangkurat, Indonesia

Background: Persistence and adherence to antidiabetic treatments are especially important to maintain glycemic control and prevent complications in diabetes mellitus (DM) patients.

Objectives: This study aimed to determine the persistence and adherence to antidiabetic treatments in Indonesian Health-Social Security Administrative Body (BPJS-Kesehatan) participants, based on antidiabetic types and classes, and the patient’s age, gender, and comorbidities.

Methods: This study used a retrospective cohort design using data sources from medical records of back-referral program for DM patients who were BPJS Kesehatan participants at a primary care clinic in Banjarmasin during 2020. Persistence was calculated by measuring the gap between prescriptions with a 14 days cutoff, while adherence was calculated with the Medication Possession Ratio (MPR) formula. The persistence data were analyzed using survival analysis. The adherence data were analyzed using the One-Way Anova, Mann-Whitney, and Kruskal-Wallis tests.

Results: A total of 77 DM patients were included, with most of the patients were < 60 years old (66.2%), males (66.2%), had comorbidities (71.4%), taken oral antidiabetic drugs (90.9%), with the most antidiabetic drug used were biguanide monotherapy (24.7%) and a combination of oral antidiabetics or a combination of oral and injected antidiabetics (58.4%). There were 67.5% DM patients who were not persistent to therapy (median of persistence of 210 days, 95%CI 171.17-248.83), but they had a good adherence (MPR value of 81.49±16,69%). There were no significant differences in medication persistence and adherence between categories of therapeutic types and classes, age, gender, and comorbidities (p > 0.05).

Conclusions: It can be concluded that the adherence to antidiabetic treatments in BPJS-Kesehatan participants in a primary care clinic in Banjarmasin was good, but the persistence was poor, and there were no differences in adherence and persistence to treatments based on the therapeutic types and classes, and patient characteristics. An effort to investigate other factors that might affect the antidiabetic drug persistence would improve the treatment of these DM patients.