Nonadherence in type 2 diabetes: practical considerations for interpreting the literature

Blackburn, David; Swidrovich, Jaris; Lemstra, Mark

doi:10.2147/ppa.s30613

Cited by 63 publications

(53 citation statements)

References 65 publications

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“…Currently, nonadherence to therapy is a common problem for patients with T2DM, and it has been associated with increases in morbidity, mortality, and healthcare costs [10, 11, 13]. If an appreciation and understanding of patients’ preference for treatment can be gained and a patient-centered approach is used during clinical decision-making, then adherence is likely to improve [7].…”

Section: Discussionmentioning

confidence: 99%

Glucagon-like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Naïve Patients with Type 2 Diabetes Mellitus: A Multinational Preference Study

Qin

Chen

Flood³

et al. 2017

Diabetes Ther

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IntroductionGlucagon-like peptide-1 receptor agonists (GLP-1RAs) differ in efficacy, side effects, dosing frequency, and device-related attributes. This study assessed the relative importance of treatment-related attributes in influencing preferences for GLP-1RAs among injection-naïve patients with type 2 diabetes mellitus (T2DM).MethodsInjection-naïve T2DM patients from five countries completed a Web-based discrete choice experiment (DCE) survey. Patients chose between hypothetical treatment profiles reflecting important and differentiating attributes of GLP-1RAs. Eight attributes were included: efficacy, side effects, device size, needle size, titration, preparation, evidence of long-term efficacy/safety, and dosing frequency. Odds ratios (ORs) and 95% confidence intervals were calculated using a conditional logit model to indicate the likelihood of choosing a treatment with a given attribute level versus a reference attribute level. The influence of individual attributes when considering full treatment profiles was examined using exenatide once weekly (QW) and liraglutide once daily (QD) as case examples.ResultsA total of 1482 patients with T2DM completed the DCE survey. Side effects, efficacy, and dosing frequency were the three most important attributes influencing preferences; needle size, device size, and required preparation were least important. Total sample analysis indicated that a profile of GLP-1RA approximating exenatide QW (single pen) was preferred over a profile approximating liraglutide QD (OR 3.36; p < 0.001), when efficacy was assumed to be equal.ConclusionThe most influential drivers of treatment preferences for a hypothetical GLP-RA profile were side effects, efficacy, and dosing frequency among injection-naïve T2DM patients. Preference elicitation can promote patient-centered care and inform new generations of T2DM treatments, which can lead to improved adherence and health outcomes.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0230-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Glucagon-like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Naïve Patients with Type 2 Diabetes Mellitus: A Multinational Preference Study

Qin

Chen

Flood³

et al. 2017

Diabetes Ther

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“…Because of the long duration of treatment, other adverse effects such as constipation, headaches, and water retention may also result in nonadherence in diabetic patients (García-Pérez et al, 2013). Poor adherence can have clinical impacts such as a decrease in glycemic control, complication of the disease, mortality, and hospitalization (American Diabetes Association [ADA], 2013; Blackburn et al, 2013;Ho et al, 2006). In this study, we did not take the data of adverse effect experienced by the patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment Adherence and Quality of Life in Diabetes Mellitus Patients in Indonesia

Perwitasari

Urbayatun

2016

SAGE Open

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Adherence to treatment of diabetes mellitus (DM) can support successful therapy due to drug consumption over longtime periods. The objectives of this study are to evaluate the treatment adherence in DM as related to the quality of life and to evaluate factors associated with adherence and quality of life. This study used the Brief Medication Questionnaire (BMQ) to measure patients’ adherence. The Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ) was used to measure patients’ quality of life. Subjects of this cross-sectional study were DM patients attending two private hospitals in Yogyakarta and who had been taking DM medications for more than 6 months. Statistical analyses used in this study were student’s t test and regression linear test. We recruited 65 DM patients who met the inclusion criteria. There were no significant differences of BMQ screens and DQLCTQ functions between monotherapy and combination therapy groups ( p> .05). The BMQ screens’ score of combination therapy were higher than monotherapy groups. The physical function, health distress, and mental health of combination therapy groups were higher than monotherapy group. The male patients had significantly higher score of regimen domain of BMQ than female patients (0.35 and 0.17, respectively). The older age has the lower score of treatment effect of DQLCTQ ( p< .05). The belief, recall, and belief about adverse drug reaction of BMQ have positive correlation with physical function ( r = .542, .424, and .640, respectively). Our study concluded that the quality of care, sex, and age may predict patients’ adherence and quality of life. There were positive correlation between patients’ adherence and quality of life.

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“…Adherence to medication in general depends on multiple factors, categorized by Blackburn et al into five groups: 1) characteristics of the patient; 2) characteristics of the treatment regimen; 3) features of the disease; 4) prescriber-level factors (including patient–physician relationship); and 5) the clinical setting 12. It has been proven that nonadherence to medication is very frequent in people with diabetes mellitus (DM),13 and leads to increased morbidity and mortality 14.…”

Section: Introduction To the Challenges Of Treating Type 2 Diabetesmentioning

confidence: 99%

Clinical utility in the treatment of type 2 diabetes with the saxagliptin/metformin fixed combination

Panagoulias¹,

Doupis²

2014

PPA

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Fixed-dose combination (FDC) products represent a widely accepted approach to type 2 diabetes treatment, given that monotherapies sometimes fail to meet the treatment targets – obtaining a sustained reduction in micro- and macrovascular complications. Saxagliptin (SAXA)/metformin (MET) FDC tablets can be used either alone or in combination with glyburide, thiazolidinediones, or insulin. It has been proven that the SAXA/MET combination leads to a significant improvement in glycemic control compared to placebo in patients with type 2 diabetes that is inadequately controlled with MET alone. In addition, this FDC has been proven to be safe for people with diabetes mellitus and established cardiovascular disease, elderly patients, and patients with impaired renal function (>30 mL/minute), with dosage modification. Patient compliance, adherence, and persistence to the therapeutic regimen has been shown to be very good, while the titration of each compound according to the patient’s profile is easy, given the availability of different formulations. The SAXA/MET FDC is a patient-friendly, dosage-flexible, and hypoglycemia-safe regimen with very few adverse events and a neutral or even favorable effect on body weight. It achieves significant glycosylated hemoglobin A1c reduction helping the patient to achieve his/her individual glycemic goals.

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Nonadherence in type 2 diabetes: practical considerations for interpreting the literature

Cited by 63 publications

References 65 publications

Glucagon-like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Naïve Patients with Type 2 Diabetes Mellitus: A Multinational Preference Study

Glucagon-like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Naïve Patients with Type 2 Diabetes Mellitus: A Multinational Preference Study

Treatment Adherence and Quality of Life in Diabetes Mellitus Patients in Indonesia

Clinical utility in the treatment of type 2 diabetes with the saxagliptin/metformin fixed combination

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