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Adherence to weight loss medications; post-marketing study from HMO pharmacy data of one million individuals.
MedLine Citation:
PMID:  21907442     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Post-marketing data on weight-loss medications in free living population are a necessary adjunct to data from clinical trials. MATERIALS AND METHODS: We conducted a population-based analysis of first-time medication users based on HMO pharmacy purchasing data serving>one million adults. RESULTS: During 5 years, usage of orlistat and sibutramine more than doubled and rates were higher during the months May-Aug. As compared to non-users (n=1,038,828), annual weight-loss drug users (n=7175) had higher women proportion, body-mass-index (BMI), bariatric surgery history, and usage of diabetes, depression, and cardiovascular medications (p<0.001 for all). Among users, men had higher BMI (34.4kg/m(2) vs. 32.5kg/m(2)), prevalence of diabetes (25.4% vs. 10.7%) and heart disease (14.2% vs. 3.5%) than women. Mean duration of purchasing weight-loss medications was 2.1 months for orlistat and 2.9 months for sibutramine. Fewer than 2% completed 12months of weight-loss medication therapy. Among the 25% who continued to purchase at least 4months, BMI (sub-group analysis) reduced from 33.02kg/m(2) to 32.04kg/m(2) (p<0.001). In a multivariate model, long-term adherence (≥4months) to weight-loss medications was associated with use of sibutramine vs. orlistat (OR=2.08; 95%CI: 1.76-2.45), and prevalence of diabetes (OR=1.20; 95%CI: 1.01-1.25). Age, gender, and baseline BMI were not associated with long-term adherence. CONCLUSIONS: Usage of weight-loss drugs is higher among diabetes patients. However, the poor adherence to therapy is substantially below levels reported in clinical trials.
Beatriz Hemo; Ronit Endevelt; Avi Porath; Meir J Stampfer; Iris Shai
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-8
Journal Detail:
Title:  Diabetes research and clinical practice     Volume:  -     ISSN:  1872-8227     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508335     Medline TA:  Diabetes Res Clin Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Research and Evaluation Unit, Maccabi Healthcare Services, Tel-Aviv, Israel.
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