Treatment Discontinuation of Oral Hypoglycemic Agents and Healthcare Utilization among Patients with Diabetes

Abstract Aims To investigate the discontinuation of oral antihyperglycemic agents (OHA), examine factors associated with OHA discontinuation, and the effect of OHA discontinuation on glycemic control and healthcare utilization among diabetes patients prescribed dual OHA therapy. Methods We identified 23,612 adult patients aged > 18 years with a diagnosis of type 2 diabetes who initiated dual OHA therapy between 1/1/2005–6/30/2010. The date of initiation of the second OHA was defined as the index date. Discontinuation was defined as a gap > 1.5 times the last days' supply without subsequent reinitiation. Results Over 24 months, 16.9% discontinued 1 OHA and 9.2% discontinued both. Patients who discontinued were more likely to be female, younger, Black or of Hispanic ethnicity, have more comorbidities, higher medication co-pays, start both OHAs together, have higher healthcare utilization before the index date and less likely to use prescription mail order compared with patients who did not discontinue. In multivariable regression models, patients who discontinued were more likely to be hospitalized or have emergency department visits during follow-up. Conclusions Discontinuation of OHAs is common among patients with diabetes and is associated with several patient factors and increased healthcare utilization. Future research should further examine reasons for OHA discontinuation.