Adherence to Oral Antidiabetic Drugs in Patients with Type 2 Diabetes: Systematic Review and Meta-Analysis

Abstract

Poor adherence to oral antidiabetic drugs (OADs) in patients with type 2 diabetes (T2D) can lead to therapy failure and risk of complications. The aim of this study was to produce an adherence proportion to OADs and estimate the association between good adherence and good glycemic control in patients with T2D. We searched in MEDLINE, Scopus, and CENTRAL databases to find observational studies on therapeutic adherence in OAD users. We calculated the proportion of adherent patients to the total number of participants for each study and pooled study-specific adherence proportions using random effect models with Freeman–Tukey transformation. We also calculated the odds ratio (OR) of having good glycemic control and good adherence and pooled study-specific OR with the generic inverse variance method. A total of 156 studies (10,041,928 patients) were included in the systematic review and meta-analysis. The pooled proportion of adherent patients was 54% (95% confidence interval, CI: 51–58%). We observed a significant association between good glycemic control and good adherence (OR: 1.33; 95% CI: 1.17–1.51). This study demonstrated that adherence to OADs in patients with T2D is sub-optimal. Improving therapeutic adherence through health-promoting programs and prescription of personalized therapies could be an effective strategy to reduce the risk of complications.

Approved and Commercialized Antidiabetic Medicines (Excluding Insulin) in Seven European Countries—A Cross-Sectional Comparison

“…Recent diabetes international guidelines and published studies provide recommendations for personalized treatment decisions, based not only on achieving optimal glycemic control, but also on patient lifestyle, personal preferences, and perception of the proposed therapy. Poor adherence to the treatment can result in treatment failure and an increased risk for complications [ 42 ]. A study conducted in Poland (DIABCON) indicated that only 65.1% of patients were compliant with the self-monitoring of blood glucose [ 43 ].…”

A Review on Affordable Combinations in Type 2 Diabetes Care: Exploring the Cost-Effective Potential of Glipizide + Metformin and Glimepiride + Metformin + Pioglitazone

“…Unsatisfactory compliance with antidiabetic medications has been observed in T2DM patients globally [10]. In India, studies with varying criteria for medication adherence have estimated medication non-compliance among diabetes patients to range from 20.5% to 66% [5,[11][12][13][14].…”

“…At an individual level, the economic burden, in addition to safety, efficacy, and ease of administration, is a major factor associated with a lack of medication adherence [20]. This trait is observed in a significant proportion (36.9%-75.1%) of T2DM patients [10,21,22] and could hasten the onset of diabetic complications. The direct costs of T2DM management include medical and nonmedical expenses borne by individuals and families, while the indirect costs include loss of productivity, among others [23].…”