42-LB: Medication Adherence in Young Adults with Youth-Onset Type 2 Diabetes: The iCount Study

Abstract

Background: Medication adherence is poor in young adults (YAs) with youth-onset type 2 diabetes (T2D). Little is known about intrapersonal factors that may relate to adherence. Aims: To assess associations of intrapersonal factors to medication adherence in Treatment Options for Adolescents and Youth (TODAY2) YAs. Methods: Validated measures (attitudes, beliefs, self-efficacy, distress, depression, anxiety) and insulin use surveys, were completed at a TODAY2 visit. Adherence to oral hypoglycemia agents (OHAs) was assessed with 3 monthly unannounced phone pill counts. Those taking ≥ 80% of pills/insulin classified “high-adherent;” < 80% of pills/insulin, “low-adherent.” If taking none, reasons were queried and adjudicated (no need vs. low-adherent). Logistic regressions assessed factors associated with OHA/insulin adherence controlling for gender, race/ethnicity, education, duration, healthcare coverage, and HbA1c. Results: Of 381 YAs in iCount (mean age 26 yrs, 68% female, 20% non-Hispanic white, 38% non-Hispanic Black, 36% Hispanic, 64.9% <$25k income, mean HbA1c 9.4%), 224 were taking OHAs. As 12 lacked adherence scores, 212 were in OHA analyses; 70.0% were low-adherent to OHAs. Negative beliefs about medicines were associated with low OHA adherence in univariate, but not multivariate analyses. No measured intrapersonal factor was associated with OHA adherence. Of 192 in insulin analyses, 37.0% were low-adherent to insulin. Low insulin adherence was associated with less belief in seriousness of T2D (p=0.036), more concern that medications are overused (p=0.005) and diabetes distress (p=0.020). Insulin adherence did not relate to other diabetes attitudes or beliefs, depressive symptoms or anxiety. Limitations: small N with high depressive/anxiety symptoms; self-reported insulin use. Conclusion: Poor medication adherence is common in YAs with youth-onset T2D. More needs to be learned about factors associated with adherence to develop tailored, effective interventions. Disclosure P. M. Trief: None. D. Uschner: None. M. Tung: None. K. Drews: None. S. Kalichman: None. B. Anderson: None. J. D. Bulger: None. R. S. Weinstock: Research Support; Self; Boehringer Ingelheim International GmbH, Diasome Pharmaceuticals, Inc., Eli Lilly and Company, Insulet Corporation, Kowa Research Institute, Inc., Medtronic, Tolerion, Inc. Funding National Institute of Diabetes and Digestive and Kidney Diseases (1RO1DK110456-01A1; U01DK61230)