Are people with schizophrenia adherent to diabetes medication? A comparative meta-analysis

Abstract

. Are people with schizophrenia adherent to diabetes medication? A comparative meta-analysis. Psychiatry Research, 250,[17][18][19][20][21][22][23][24] https://doi.org/10.1016/j.psychres.2017.01.049Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections. General rightsCopyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights.•Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research.•You may not further distribute the material or use it for any profit-making activity or commercial gain •You may freely distribute the URL identifying the publication in the Research Portal Take down policy If you believe that this document breaches copyright please contact librarypure@kcl.ac.uk providing details, and we will remove access to the work immediately and investigate your claim. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. AbstractIndividuals living with schizophrenia are 2-3 times more likely to experience type 2 diabetes mellitus. Diabetes medication adherence is essential to reduce morbidity and mortality in this population. We conducted a meta-analysis of diabetes medication adherence among people with schizophrenia, and compared this to those without schizophrenia. A systematic search strategy was used to identify all articles reporting adherence to diabetes medications among patients with schizophrenia. In total, 10 unique studies reporting data from 33,910 people with schizophrenia were included. Random effects meta-analysis showed people with schizophrenia adhered to medication on 77.3% of days prescribed (n=32080, 95%CI=73.6%-81%, I²=99.2%,), and adhered on 4.6% more days per year than those without schizophrenia (p<0.01, 95%CI=2.4%-6.7%, I²=92.5%, schizophrenia n=19367, controls=170,853).Furthermore, 56% of individuals with schizophrenia (n=33680) were considered "adherent"(i.e. >80% adherence over 12-24 month) to diabetes medication, which was signifi...

The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness

“…127 Furthermore, recent data have shown that people with schizophrenia are equally adherent to diabetes medication as the general population, thus further supporting the need for healthcare providers to remain optimistic about prescribing cardiometabolic medications in people with mental illness. 128 Finally, access may be compromised by financial costs, fragmentation of care and stigma. 124,126,129 Although health care should be the one sector where challenging behaviour might be recognized as a symptom of illness, there is evidence that various healthcare providers have stigmatised views on people with mental illness.…”

Erythropoietin for Cognitive Deficits Associated with Schizophrenia, Bipolar Disorder, and Major Depression: A Systematic Review

“…Second, only 4 studies with 144 patients were included; thus, the findings are still preliminary. Third, cognitive deficits are closely associated with metabolic syndrome [26] and non-insulin-dependent diabetes mellitus [31], which are prevalent in a sizeable proportion of patients with severe mental illness [32,33]. All the RCTs included only physically healthy patients, which limits the generalization of the findings in clinical practice.…”

Pharmacological management of diabetes in severe mental illness: a comprehensive clinical review of efficacy, safety and tolerability

“…Trial data in relation to the use of antidiabetic medications (except for metformin) in services. Meta-analysis has shown that 56% of people with schizophrenia (n=33680) are "adherent" to diabetes medication, which was significantly higher than those without schizophrenia, indicating that diabetic medication programs can be successfully implemented in this population [58]. We believe that future clinical trials that investigate treatment efficacy and switching strategies in T2DM patients in SMI will increase our knowledge, familiarity and confidence in using these agents and lead to increased treatment implementation for T2DM in this population.…”

“…We will focus on pharmacological treatments used to manage T2DM in the general population, most of which have little trial exposure in SMI populations. Support for this approach is emphasized in a recent meta-analysis of 10 studies reporting data from 33,910 people with schizophrenia and T2DM which found that people with schizophrenia adhered to diabetic medication on 77.3% of days prescribed (n=32080, 95%CI=73.6-81%, I 2 =99.2%,), and adhered on 4.6% more days per year than those without schizophrenia (p<0.01, 95%CI=2.4-6.7%, I 2 =92.5%, schizophrenia n=19367, controls=170,853) [58].…”