A Review of Diabetes Treatment Adherence and the Association with Clinical and Economic Outcomes

Self-report measures of medication adherence behavior: recommendations on optimal use

“…In type 2 diabetes, few studies have tested the relationship between glycemic control and self-report of medication adherence [2]. Although some diabetes research supports the validity of self-report measures [19,53], a review of diabetes treatment adherence studies found that just 42.9 % (6 of 14) of studies that used self-report measures found a statistically significant relationship with HbA1c levels [18].…”

“…Most evidence shows that medication adherence plays an important role in glycemic control, but many other factors can affect glycemic control besides medicationtaking (e.g., diet, exercise, extent of insulin deficiency, and adequacy of the prescribed regimen), so comparisons of self-report medication adherence measures to the clinical outcome of HbA1c levels should show a modest relationship at best. Expectations regarding the ability of self-report measures to predict clinical outcomes should be set accordingly [2,53] [18,51,54]. A review of type 2 diabetes research found that significant relationships between medication adherence and glycemic control occurred more frequently in studies measuring adherence via prescription refill rather than various self-report measures [18].…”

“…Expectations regarding the ability of self-report measures to predict clinical outcomes should be set accordingly [2,53] [18,51,54]. A review of type 2 diabetes research found that significant relationships between medication adherence and glycemic control occurred more frequently in studies measuring adherence via prescription refill rather than various self-report measures [18]. A review of type 1 diabetes research found that the relation between adherence to diabetes management behaviors and glycemic control in type 1 diabetes showed no overall differences when using either self-reports or blood glucose meter downloads, but studies using self-report measures showed significant heterogeneity in their effect size estimates, whereas meters showed little variability [19].…”

“…IMPACT OF MEDICATION ADHERENCE Across many chronic medical conditions, adherence has been associated with positive clinical outcomes including improved disease control, reduced symptoms, and decreased complications, hospitalization, and mortality [13][14][15][16][17][18][19][20]. Even modest nonadherence (e.g., 10-20 %) has been linked with clinically significant deteriorations in health outcomes, such as glycemic control, low-density lipoprotein cholesterol levels, and risk for coronary disease [21,22], as well as failure to achieve health improvements [23], leading to higher healthcare costs [21,24].…”

“…In type 2 diabetes, few studies have tested the relationship between glycemic control and self-report of medication adherence [2]. Although some diabetes research supports the validity of self-report measures [19,53], a review of diabetes treatment adherence studies found that just 42.9 % (6 of 14) of studies that used self-report measures found a statistically significant relationship with HbA1c levels [18].Variable correspondence between self-report adherence and clinical outcomes across chronic conditions may reflect variation in the strength of the adherence-outcomes relationship across different illnesses. In type 2 diabetes adherence research, Gonzalez and colleagues [53] noted that modest relationships between self-report measures and clinical outcomes may partially reflect a modest effect of medication (even when regularly taken) on clinical outcomes.…”