Endocrine Abstracts (2016) 41 EP439 | DOI: 10.1530/endoabs.41.EP439

The effect of processes measures of diabetes care and medication adherence on the developments of chronic diabetic complications

Soo-Kyung Kim1, Se-Hwa Kim2, Kyung Do Han3, Eun-Mi Kim4, Jin-Sook Cho4, Seok O Park5, Tae Sun Park6 & Yong-Wook Cho1

1CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea; 2Catholic Kwandong University, Incheon, Republic of Korea; 3College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 4Health Insurance Review & Assessment Service, Wonju, Republic of Korea; 5Kwangmyung Sungae Hosiptal, Gwangmyeong, Republic of Korea; 6Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Republic of Korea.

Background: Regular monitoring of glucose control and screening of diabetic complication and adherence to treatment are cornerstones for prevention of chronic diabetic complications. The aim of this study is to investigate the association between quality of diabetes care and the development of chronic diabetes complications.

Methods: This retrospective study was performed using the national health insurance claims database from the Health Insurance Review & Assessment Service (HIRA) of Korea. Study patients were aged 30 years or older, had type 2 diabetes, had taking at least one hypoglycemic agent in only one attending clinic at 2009, and had no history of any diabetes-related chronic complications including cardiovascular diseases before December 2010, cancer, or hospitalization for ≥90 days (n=280 698). Patients who measured HbA1c and lipid profile at least once a year every year and had ≥80% of the possession rate of oral hypoglycemic medication every year from 2009 to 2014 were compared with those who did not.

Results: The number of patients receiving two quality-of-care measures at least once a year increased to 52.5% in 2014 from 30.3% in 2009. Those having ≥80% of the medication adherence also increased from 60.3 to 73.5%. However, the patients who meet both conditions every year during study period were only 13 625 (4.9%). In them, the cumulative incidence of microvascular complications (nephropathy and retinopathy) was 4.1%, and that of macrovascular complications (myocardial and cerebral infarction and peripheral arterial disease) was 0.8%, (4.8 and 1.5%, respectively in those who did not).

Conclusions: The proportion of patients who received two quality-of-care measures and had ≥80% of the medication possession rate every year are seriously low, but they experienced fewer diabetic macrovascular complications. This result provides support for the importance for enhancing the quality of diabetes care.

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