Association Between Adherence to Pharmacotherapy and Outcomes in Type 2 Diabetes: A Meta-analysis

Abstract

We identified no trials reporting on outcomes by adherence, suggesting a systematic failure to include this information. Pooled estimates from available observational studies suggest that good medication adherence is associated with reduced risk of all-cause mortality and hospitalization in people with type 2 diabetes, although bias cannot be excluded as an explanation for these findings.

Adherence to medication, glycaemic control and hospital attendance in young adults with type 2 diabetes

“…We also found that men had slightly better average adherence than women, possibly because many women were busy with their young families with a tendency to neglect their own health. A recent meta‐analysis of the association between adherence and outcomes in type 2 diabetes also found that adherence was better in men . Other factors that have been linked to poor adherence include low education levels, low income and polypharmacy, all of which are major issues in young people with type 2 diabetes.…”

“…Attendance to hospital was significantly related to both adherence and HbA1c. In meta‐analyses of studies that examined medication adherence and outcomes in type 2 diabetes (largely in middle‐aged subjects), better adherence has been associated both with a lower rate of hospitalisation and lower all‐cause mortality …”

“…Low levels of adherence to medication may thus be a critical factor in the poor glycaemic control often seen in young‐onset type 2 diabetes, but one that has been little explored. Poor adherence has also been related to the risk of hospital admission and mortality …”

Adherence to medical follow‐up recommendations reduces hospital admissions: Evidence from diabetic patients in France

“…Despite the recent shift in health policy towards reinforcing the role of primary care to relieve the demand for inpatient care in France, convincing evidence regarding the effects of the adherence level to the specific diabetes guidelines regarding health care utilization in general and hospital admissions in particular is limited. The international literature based on linear models has established that patients with a lower adherence to medical follow‐up have a higher risk of hospital use ( Encinosa, Bernard, & Dor, ; Ho et al, ; Huber, Brändle, Rapold, Reich, & Rosemann, ; Jha, Aubert, Yao, Teagarden, & Epstein, ; Khunti, Seidu, Kunutsor, & Davies, ; Mojtabai & Olfson, ; Reed et al, ). Diabetic patients with a lower adherence to medical follow‐up have higher risks of diabetes complications ( Grintsova, Maier, & Mielck, ) , resulting in a higher risk of hospital admission ( Andrade, Rapp, & Sevilla‐Dedieu, ; Wagner et al, ) , unplanned hospitalizations ( Dusheiko, Gravelle, Martin, Rice, & Smith, ) , and readmission ( Rubin , ).…”

Adherence and diabetes

“…Adherence does not only include the use of medications; healthy lifestyle adherence in type 2 diabetes mellitus (T2DM) is associated with a 30% reduction in mortality . For T2DM, reported mean medication adherence rates are only between 30% and 40%, with good versus poor adherence associated with a greater risk of mortality and hospitalization . Similar benefits have been shown with low‐dose aspirin and with angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers …”