Evidence map›Paper›PMID 33023898›Full record

Trial reportBMJ open diabetes research & care2020

Long-term metformin adherence in the Diabetes Prevention Program Outcomes Study.

Elizabeth Arquin Walker, Jeffrey S Gonzalez, Mark T Tripputi, Samuel Dagogo-Jack, Margaret J Matulik, Maria G Montez, Sameh Tadros, Sharon L Edelstein, DPP Research Group

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Review
  5. Article
  6. Review
  7. Article
  8. Article
  9. Review
  10. Persistence as a Robust Indicator of Medication Adherence-Related Quality and Performance.International journal of environmental research and public health · 2021
    Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Elizabeth Arquin WalkerMedicine, Albert Einstein College of Medicine, Bronx, New York, USA.ORCID 0000-0002-6328-7673
Jeffrey S GonzalezMedicine, Albert Einstein College of Medicine, Bronx, New York, USA.
Mark T TripputiThe Biostatistics Center, The George Washington University Milken Institute of Public Health, Washington, District of Columbia, USA.
Samuel Dagogo-JackDivision of Endocrinology, Diabetes & Metabolism General Clinical Research Center, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.ORCID 0000-0001-5318-9677
Margaret J MatulikMedicine, University of Chicago, Chicago, Illinois, USA.
Maria G MontezMedicine, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas, USA.
Sameh TadrosMedicine, University of California at Los Angeles, Los Angeles, California, USA.
Sharon L EdelsteinThe Biostatistics Center, The George Washington University Milken Institute of Public Health, Washington, District of Columbia, USA dppmail@bsc.gwu.edu.ORCID 0000-0001-8457-4404
DPP Research Group
Albert Einstein College of Medicine · USMilken Institute · USThe University of Texas Health Science Center at San Antonio · USUniversity of California, Los Angeles · USUniversity of Chicago · USUniversity of Tennessee Health Science Center · US

Funding

PRIMARY PREVENTION TRIAL--DATA COORDINATING CENTERU01DK048489 · GEORGE WASHINGTON UNIVERSITY · 1994 to 2005
$23.7M
Post-DDP Follow-up StudyU01DK048413 · UNIVERSITY OF WASHINGTON · 1994 to 2005
$4.4M
TITLE OMITTEDU01DK048349 · YESHIVA UNIVERSITY · 1994 to 2005
$4.0M
PRIMARY PREVENTION TRIALU01DK048443 · UNIVERSITY OF SOUTHERN CALIFORNIA · 1994 to 2005
$4.0M
PRIMARY PREVENTION TRIAL (DPT-2)U01DK048397 · MASSACHUSETTS GENERAL HOSPITAL · 1994 to 2005
$3.8M
Post-DPP Follow-up StudyU01DK048485 · JOHNS HOPKINS UNIVERSITY · 1994 to 2005
$3.7M
NIDDM PRIMARY PREVENTION TRIALU01DK048412 · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 1994 to 2005
$3.6M
PRIMARY PREVENTION TRIAL (DPT-2)U01DK048339 · UNIVERSITY OF CALIFORNIA SAN DIEGO · 1994 to 2005
$3.6M
Post-DPP Follow-Up StudyU01DK048400 · WASHINGTON UNIVERSITY · 1994 to 2005
$3.6M
Post-DPP Follow-up StudyU01DK048437 · JOSLIN DIABETES CENTER · 1994 to 2005
$3.5M
NIDDM PRIMARY PREVENTION TRIAL (DPT 2)U01DK048404 · ST. LUKE'S-ROOSEVELT INST FOR HLTH SCIS · 1994 to 2005
$3.5M
PRIMARY PREVENTION TRIALU01DK048387 · MEDSTAR RESEARCH INSTITUTE · 1994 to 2005
$3.3M
NIDDK NIH HHS P30 DK020541NIDDK NIH HHS P30 DK111022NIDDK NIH HHS U01 DK048339NIDDK NIH HHS U01 DK048349NIDDK NIH HHS U01 DK048375NIDDK NIH HHS U01 DK048380NIDDK NIH HHS U01 DK048381NIDDK NIH HHS U01 DK048387NIDDK NIH HHS U01 DK048397NIDDK NIH HHS U01 DK048400NIDDK NIH HHS U01 DK048404NIDDK NIH HHS U01 DK048407NIDDK NIH HHS U01 DK048412NIDDK NIH HHS U01 DK048413NIDDK NIH HHS U01 DK048434NIDDK NIH HHS U01 DK048437NIDDK NIH HHS U01 DK048443NIDDK NIH HHS U01 DK048468NIDDK NIH HHS U01 DK048485NIDDK NIH HHS U01 DK048489NIDDK NIH HHS U01 DK048514
6 · The paper itself

Abstract

introductionTo investigate long-term metformin adherence in the Diabetes Prevention Program Outcomes Study (DPPOS) by examining: (1) predictors of long-term adherence to study metformin and (2) whether metformin adherence was associated with incident type 2 diabetes. RESEARCH DESIGN AND

methodsDPPOS was an open-label continuation of the randomized clinical trial (Diabetes Prevention Program (DPP)) in which eligible participants randomized to the metformin group were offered study metformin and followed over 11 years. A brief structured adherence interview was administered semiannually. Metformin adherence was assessed by pill counts. Predictors of metformin adherence were examined in multivariate regression models. Incident diabetes associated with metformin adherence and other variables was assessed in Cox proportional hazards models.

resultsOf 868 participants eligible to continue taking study metformin, 664 (76%) took at least some metformin over 11 years, with 478 of them reporting problems with adherence. DPPOS cumulative adherence showed significant associations of higher adherence (≥80%) with early adherence at 3 months in DPP (p<0.001) and lower depression scores during DPPOS (p<0.001); significant differences were also seen by race/ethnicity (p<0.004). Predicting adherence by multivariate modeling showed odds of adherence significantly lower for Black participants and for participants reporting more than one barrier. Odds for adherence were significantly higher for those adherent early in DPP and those reporting at least one planned strategy to improve adherence. Higher metformin adherence was significantly associated with a lower diabetes risk (p=0.04), even after adjustment for demographic variables, depression, and anxiety scores.

conclusionsIn this long-term diabetes prevention study, early metformin adherence and planned strategies to promote adherence improved long-term adherence over 11 years; higher adherence to metformin was related to lower diabetes incidence. Incorporating strategies to promote adherence when initially prescribing metformin and counseling to support adherence over time are warranted.

Indexed as

Diabetes Mellitus, Type 2MetforminEthnicityHumansHypoglycemic AgentsIncidenceHypoglycemic AgentsMetformindiabetes mellitusmedication adherencemetforminpreventive medicinetype 2

Identifiers

PMID33023898
PMCPMC7539607
OpenAlexW3091886219

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.