Adherence to hypoglycaemic medication among people with type 2 diabetes in primary care

作者：White Anthony J S; Kellar Ian^*; Prevost Andrew T; Kinmonth Ann L; Sutton Stephan; Canny Melissa; Griffin Simon J

来源：Primary Care Diabetes, 2012, 6(1): 27-33.

DOI：10.1016/j.pcd.2011.07.004

• Type 2 diabetes
• MEMS
• Adherence
• Primary care
• Oral agents

Aims: To assess levels and correlates of adherence to hypoglycaemic medication among patients offered organised general practice diabetes care.
Methods: 60 patients prescribed oral hypoglycaemic medication were recruited to a two-month prospective study. Prescribed doses taken and days on which the prescribed number of doses was taken were measured by MEMS (Medication Event Monitoring System).
Results: Overall 99.1% of prescribed doses were taken (median, IQR: 96.8-100%), this was inversely correlated with daily dose frequency (Spearman's rho = 0.37, p = 0.004). Only 4 patients (6.7%) took less than 90% of prescribed doses. The prescribed dose was taken on 96.4% of days (median, IQR: 89.1-98.2%), this was correlated with age (rho = 0.26, p = 0.047) and inversely correlated with HbA(1c) levels (rho = -0.29, p = 0.02) and daily dose frequency (rho = -0.33, p = 0.009). Adherence to metformin was less than to other hypoglycaemic medication (Z = -3.48, p = 0.0005).
Conclusions: A dispensing practice with a well-run diabetes service can support high rates of adherence to hypoglycaemic medication. Before changing medication, low adherence might be considered as a possible cause of progressive hyperglycaemia, particularly among patients prescribed metformin more than once a day. Selective monitoring with MEMS may have a clinical as well as a research role in such people.

• 出版日期2012-4