Adherence to hypoglycaemic medication among people with type 2 diabetes in primary care.
Primary care diabetes 2011 ; 6: 27-33.
White AJ, Kellar I, Prevost AT, Kinmonth AL, Sutton S, Canny M, and Griffin SJ
DOI : 10.1016/j.pcd.2011.07.004
PubMed ID : 21840277
PMCID : 0
To assess levels and correlates of adherence to hypoglycaemic medication among patients offered organised general practice diabetes care.
60 patients prescribed oral hypoglycaemic medication were recruited to a two-month prospective study. Prescribed doses taken and days on which the prescribed number of doses was taken were measured by MEMS (Medication Event Monitoring System).
Overall 99.1% of prescribed doses were taken (median, IQR: 96.8-100%), this was inversely correlated with daily dose frequency (Spearman's rho=0.37, p=0.004). Only 4 patients (6.7%) took less than 90% of prescribed doses. The prescribed dose was taken on 96.4% of days (median, IQR: 89.1-98.2%), this was correlated with age (rho=0.26, p=0.047) and inversely correlated with HbA(1c) levels (rho=-0.29, p=0.02) and daily dose frequency (rho=-0.33, p=0.009). Adherence to metformin was less than to other hypoglycaemic medication (Z=-3.48, p=0.0005).
A dispensing practice with a well-run diabetes service can support high rates of adherence to hypoglycaemic medication. Before changing medication, low adherence might be considered as a possible cause of progressive hyperglycaemia, particularly among patients prescribed metformin more than once a day. Selective monitoring with MEMS may have a clinical as well as a research role in such people.