Metformin adherence in patients with type 2 diabetes and its association with glycated haemoglobin levels

作者：Lynne M. Chepulis, Christopher Mayo, Brittany J. Morison, Rāwiri Keenan, Chunhuan Lao, Ryan G. Paul, Ross A Lawrenson · 发表于：Journal of Primary Health Care · 年份：2020 · DOI：10.1071/hc20043 · 被引用次数：35 · 研究领域：Diabetes Treatment and Management、Diabetes Management and Research、Diabetes Management and Education

INTRODUCTION Metformin is the initial medication of choice for most patients with type 2 diabetes. Non-adherence results in poorer glycaemic control and increased risk of complications. AIM The aim of this study was to characterise metformin adherence and association with glycated haemoglobin (HbA1c) levels in a cohort of patients with type 2 diabetes. METHODS Prescription and dispensing data were used for this study. Primary care clinical and demographic data were collected from 10 general practices (October 2016-March 2018) and linked to pharmaceutical dispensing information. Metformin adherence was initially measured by calculating the proportion of patients who had optimal medication cover for at least 80% of days (defined as a medication possession ratio (MPR) of ≥0.8), calculated using dispensing data. Prescription adherence was assessed by comparing prescription and dispensing data. The association between non-adherence (MPR <0.8) and HbA1c levels was also assessed. RESULTS Of the 1595 patients with ≥2 metformin prescriptions, the mean MPR was 0.87. Fewer Māori had an MPR ≥0.8 than New Zealand European (63.8% vs. 81.2%). Similarly, Māori received fewer metformin prescriptions (P=0.02), although prescription adherence did not differ by ethnicity. Prescription adherence was lower in younger patients (P=0.002). Mean HbA1c levels were reduced by 4.8 and 5.0mmol/mol, respectively, in all and Māori patients with an MPR ≥0.8. Total prescription adherence reduced HbA1c by 3.2m...