Adherence and persistence rates of major antidiabetic medications: a review

Abstract

The objective of this paper was to review the adherence and persistence rates of major antidiabetic medication classes (i.e., metformin, sulfonylureas, sodium glucose cotransporter-2 inhibitors, dipeptidyl peptidase-4 inhibitors, insulin, glucagon-like peptide-1 receptor agonists, and thiazolidinediones) by summarizing the major findings of the studies published since 2017. In addition, we reported the potential causes for low adherence and persistence of antidiabetic medications. Based on the literature, the highest rate of adherence and persistence was consistently observed in metformin users. Second to metformin were sodium glucose cotransporter-2 inhibitors. Injectable therapies such as insulin and glucagon-like peptide-1 receptor agonists trailed low on the adherence and persistence rates. To the best of our knowledge, no studies published since the year 2017 analyzed the adherence and persistence of thiazolidinediones independently. The most frequently cited cause for low adherence and persistence was the severity of adverse events. Baseline characteristics (e.g., baseline HbA1c level), demographic information (e.g., age, gender, or ethnicity), and comorbidity profiles also had significant impacts on adherence and persistence in patients with type 2 diabetes mellitus.

Safety and effectiveness of dulaglutide 0.75 mg in Japanese patients with type 2 diabetes in real‐world clinical practice: 36 month post‐marketing observational study

“…In the overall population, the continuation rate for dulaglutide was 76.6% at 12 months and 58.0% at 36 months. These data are consistent with previous findings of high persistence rates with dulaglutide, which are significantly higher than those of other GLP-1 RAs 24 . Although methodology differences should be considered, treatment persistence for dulaglutide in the current study was also higher than all classes of oral antidiabetic medications at 12 (~≤ 60%) and 30 (~≤ 50%) months in a retrospective study of Japanese patients with type 2 diabetes using a real-world claims-based database 25 .…”

Long-Term Influence of Locus of Control and Quality of Life on Metabolic Profile in Elderly Subjects with Type 2 Diabetes

“…Another aspect to consider is that our study is mono-centric, therefore our patients were habitually followed at the same second level diabetes outpatient clinic, undergoing at least two specialist visits throughout the year, and this aspect might have influenced the perceived impact of external help on diabetes management. Thus, the doctor-patient relationship is an acknowledged factor influencing adherence and consequently glucose control [ 31 ]. In line with this hypothesis, elderly subjects in our study were overall satisfied with the plan of care, as shown by the DTSQ (Diabetes Treatment Satisfaction Questionnaire) scores [ 16 ]; they also showed a low-medium burden from hyper- and hypo-glycemia, as indicated by mean scores in DTSQ 1 and 2 items; a good level of satisfaction may positively influence adherence and metabolic control, also with a lower impact on QoL.…”

Glucose-lowering effects of orally administered superoxide dismutase in type 2 diabetic model rats

“…The complications of diabetes caused by hyperglycemia, the main syndrome of diabetes, continue to be a large and increasing global health burden 1 , 2 . Furthermore, there are problems with existing drugs, such as treatment failure, gastrointestinal side effects, weight gain, and/or hypoglycemia 3 . Therefore, it is urgent to develop alternative glucose-lowering approaches for diabetes.…”