Adherence to SMBG was suboptimal. The most significant factors that interfered with adherence were having type 2 diabetes and environmental barriers. Knowing the importance of these factors may assist diabetes educators and other healthcare professionals in identifying people at risk for low adherence to SMBG and potentially long-term health complications.

Adherence measures in our study were low. Although they were significantly better for extended-release methylphenidate-OROS than the other stimulants, the clinical significance of these differences are unclear. Further research should be conducted regarding pharmaceutical products, administration methods, and clinical interventions that may enhance adherence.

ADHD medication adherence and persistence was suboptimal. Although there was no difference in adherence between long-acting stimulant and non-stimulant users, non-stimulant users were more persistent compared to stimulant users. This study was limited due to the use of retrospective prescription claims data, which cannot capture actual patient use patterns, ICD-9 diagnoses, family history and support, or side effect profiles. Because ADHD can be effectively treated with pharmacotherapy, providers should be proactive in identifying patients with poor adherence and intervene to address barriers to medication adherence and persistence.

This study increased awareness of barriers to medication adherence in a predominantly Hispanic underserved patient population. This may lead to more informed recommendations and perhaps address gaps in health disparities.