Evidence map›Paper›PMID 37874585›Full record

ArticleThe European journal of general practice2023

Non-adherence to non-insulin glucose-lowering drugs: Prevalence, predictors and impact on glycemic control and insulin initiation. A longitudinal cohort study in a large primary care database in Spain.

Rocío Zamanillo-Campos, María Zaforteza Dezcallar, Maria Asunción Boronat Moreiro, Alfonso Leiva Rus, Joana Ripoll Amengual, Jadwiga Konieczna, Maria Antonia Fiol-deRoque, Ignacio Ricci-Cabello

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Article in The European journal of general practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Rocío Zamanillo-CamposHealth Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain.
María Zaforteza DezcallarPharmacy Service, Balearic Islands Health Service, Palma, Spain.
Maria Asunción Boronat MoreiroPharmacy Service, Balearic Islands Health Service, Palma, Spain.
Alfonso Leiva RusHealth Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain.
Joana Ripoll AmengualHealth Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain.
Jadwiga KoniecznaCIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Madrid, Spain.
Maria Antonia Fiol-deRoqueHealth Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain.
Ignacio Ricci-CabelloHealth Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA better understanding of patient non-adherence to type 2 diabetes medication is needed to design effective interventions to address this issue.

objectives(1) To estimate the prevalence of non-adherence to diabetes medication; (2) to examine its impact on glycemic control and insulin initiation; (3) to develop and validate a prediction model of non-adherence.

methodsWe conducted a longitudinal cohort study based on data from electronic health records. We included adult patients registered within the Health Service of the Balearic Islands (Spain) starting a new prescription of a non-insulin glucose-lowering drug between January 2016 and December 2018. We calculated non-adherence at 12 months follow-up, defined as medication possession ratio (MPR) ≤ 80%. We fitted multivariable regression models to examine the association between non-adherence and glycemic control and insulin initiation and identified predictors of non-adherence.

resultsOf 18,119 patients identified, after 12 months follow-up, 5,740 (31.68%) were non-adherent. Compared with non-adherent, adherent patients presented lower HbA1c levels (mean difference = -0.32%; 95%CI = -0.38%; -0.27%) and were less likely to initiate insulin (aOR = 0.77; 95%CI = 0.63; 0.94). A predictive model explained 22.3% of the variation and presented a satisfactory performance (AUC = 0.721; Brier score = 0.177). The most important predictors of non-adherence were: non-Spanish nationality, currently working, low adherence to previous drugs, taking biguanides, smoker and absence of hypertension.

conclusionAround one-third of the patients do not adhere to their non-insulin glucose-lowering drugs. More research is needed to optimise the performance of the predicting model before considering its implementation in routine clinical practice.

Indexed as

Diabetes Mellitus, Type 2InsulinAdultCohort StudiesGlucoseGlycemic ControlHumansHypoglycemic AgentsLongitudinal StudiesMedication AdherencePrevalencePrimary Health CareRetrospective StudiesSpainGlucoseHypoglycemic AgentsInsulincomplianceLongitudinal studymedication adherencemedication possession ratiotype 2 diabetes mellitus

Identifiers

PMID37874585
PMCPMC10990259

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LicenceCC BY-NC
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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.