Duru, O KenrikBilik, DoriMcEwen, Laura N.Brown, Arleen F.Karter, Andrew J.Curb, J DavidMarrero, David G.Lu, Shou-EnRodriguez, MichaelMangione, Carol M.2013-08-292013-08-292010-12O Kenrik Duru MD, M. S., Brown, A. F., Rodriguez, M., & Mangione, C. M. (2011). Primary language, income and the intensification of anti-glycemic medications in managed care: the (TRIAD) study. Journal of general internal medicine, 26(5), 505-511.https://hdl.handle.net/1805/3484BACKGROUND Patients who speak Spanish and/or have low socioeconomic status are at greater risk of suboptimal glycemic control. Inadequate intensification of anti-glycemic medications may partially explain this disparity. OBJECTIVE To examine the associations between primary language, income, and medication intensification. DESIGN Cohort study with 18-month follow-up. PARTICIPANTS One thousand nine hundred and thirty-nine patients with Type 2 diabetes who were not using insulin enrolled in the Translating Research into Action for Diabetes Study (TRIAD), a study of diabetes care in managed care. MEASUREMENTS Using administrative pharmacy data, we compared the odds of medication intensification for patients with baseline A1c ≥ 8%, by primary language and annual income. Covariates included age, sex, race/ethnicity, education, Charlson score, diabetes duration, baseline A1c, type of diabetes treatment, and health plan. RESULTS Overall, 42.4% of patients were taking intensified regimens at the time of follow-up. We found no difference in the odds of intensification for English speakers versus Spanish speakers. However, compared to patients with incomes <15,000,patientswithincomesof15,000-39,999(OR1.43,1.07−1.92),40,000-74,999(OR1.62,1.16−2.26)or>75,000 (OR 2.22, 1.53-3.24) had increased odds of intensification. This latter pattern did not differ statistically by race. CONCLUSIONS Low-income patients were less likely to receive medication intensification compared to higher-income patients, but primary language (Spanish vs. English) was not associated with differences in intensification in a managed care setting. Future studies are needed to explain the reduced rate of intensification among low income patients in managed care.en-USType 2 diabetesSocioeconomic Factorsmanaged care programsanti-glycemic medicationsArticle