A brief adherence intervention that improved glycemic control: mediation by patterns of adherence

Abstract

This study examined whether longitudinal adherence profiles mediated the relationship between a brief adherence intervention and glycemic control among patients with Type 2 diabetes. Adherence was assessed using the Medication Event Monitoring System (MEMS). Longitudinal analysis via growth curve mixture modeling was carried out to classify patients according to patterns of adherence to oral hypoglycemic agents. Hemoglobin A1c (HbA1c) assays were used to measure glycemic control as the clinical outcome. Across the whole sample, longitudinal adherence profiles mediated 35.2% (13.2%, 81.0%) of the effect of a brief adherence intervention on glycemic control (from odds ratio (OR) = 8.48, 95% CI (3.24, 22.2) to 4.00, 95% CI (1.34, 11.93)). Our results suggest that patients in the intervention had better glycemic control largely due to their greater likelihood of adherence to oral hypoglycemic agents.

Comparison of persistence and adherence between fixed-dose combinations and two-pill combinations in Japanese patients with type 2 diabetes

“…In the same study it was reported that each 10% increase in oral anti-diabetic medication adherence was associated with a 0.1% decrease in HbA 1c (p ¼ .0004) 13 . More recently, the relationship between medication adherence and improved glycemic control has also been published 25 . Reducing treatment complexity will help meet the current ADA Standards of Medical Care in Diabetes recommendations, which advocate a patient-centered approach to managing diabetes care and the encouragement of treatment adherence 26 .…”

Medication adherence in type 2 diabetes mellitus patients: a cross-sectional study

“…19 The prevalence of depression is higher in patients with type 2 diabetes as compared to nondiabetic population, conditioning lower glycemic control, higher risk of complications and poorer self-care behaviors, such as adherence to drug therapy. [20][21][22][23] Evidence suggests that interventions explicitly tailored to the individual may be the most effective in producing clinically meaningful results, 24 but family support and patients' trust in their physicians have also been recognized as a stimulus for better adherence both to medications and healthy lifestyles, with impact on diabetes' control. [25][26] Few studies have investigated the adherence to medication in Portuguese patients with T2DM.…”

Great diversity in the utilization and reporting of latent growth modeling approaches in type 2 diabetes: A literature review

“…A total of 6 studies considered within-class heterogeneity by using LGMM [ 12 , 13 , 14 , 15 , 16 ] or a General Growth Class Mixture Modeling (GGCMM) for randomized intervention [ 17 , 18 ]. Most studies (n = 32) used LCGA.…”