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Comparison of medication adherence and persistence in type 2 diabetes: A systematic review and meta-analysis

Mcgovern, Andrew, Tippu, Z, Hinton, William, Munro, N, Whyte, Martin and de Lusignan, Simon (2017) Comparison of medication adherence and persistence in type 2 diabetes: A systematic review and meta-analysis Diabetes, Obesity and Metabolism, 20 (4). pp. 1040-1043.

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Abstract

Limited medication adherence and persistence with treatment are barriers to successful management of type 2 diabetes (T2D). We searched MEDLINE, EMBASE, the Cochrane Library, the Register of Controlled Trials, PsychINFO and CINAHL for observational and interventional studies that compared the adherence or persistence associated with 2 or more glucose-lowering medications in people with T2D. Where 5 or more studies provided the same comparison, a random-effects meta-analysis was performed, reporting mean difference (MD) or odds ratio (OR) for adherence or persistence, depending on the pooled study outcomes. We included a total of 48 studies. Compared with metformin, adherence (%) was better for sulphonylureas (5 studies; MD 10.6%, 95% confidence interval [CI] 6.5-14.7) and thiazolidinediones (TZDs; 6 studies; MD 11.3%, 95% CI 2.7%-20.0%). Adherence to TZDs was marginally better than adherence to sulphonylureas (5 studies; MD 1.5%, 95% CI 0.1-2.9). Dipeptidyl peptidase-4 inhibitors had better adherence than sulphonylureas and TZDs. Glucagon-like peptide-1 receptor agonists had higher rates of discontinuation than long-acting analogue insulins (6 studies; OR 1.95; 95% CI 1.17-3.27). Longacting insulin analogues had better persistence than human insulins (5 studies; MD 43.1 days; 95% CI 22.0-64.2). The methods used to define adherence and persistence were highly variable.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Mcgovern, Andrewa.p.mcgovern@surrey.ac.uk
Tippu, Z
Hinton, Williamw.hinton@surrey.ac.uk
Munro, N
Whyte, Martinm.b.whyte@surrey.ac.uk
de Lusignan, SimonS.Lusignan@surrey.ac.uk
Date : 14 November 2017
Identification Number : 10.1111/dom.13160
Copyright Disclaimer : This is the peer reviewed version of the following article: McGovern A, Tippu Z, Hinton W, Munro N, Whyte M, de Lusignan S. Comparison of medication adherence and persistence in type 2 diabetes: A systematic review and meta-analysis. Diabetes Obes Metab. 2017;1–4. https://doi.org/10.1111/dom.13160, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/dom.13160/full. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Uncontrolled Keywords : antidiabetic drug, GLP-1 analogue, insulin analogues, medication adherence, medication persistence, meta-analysis, systematic review, type 2 diabetes
Depositing User : Melanie Hughes
Date Deposited : 19 Dec 2017 14:21
Last Modified : 15 May 2018 15:16
URI: http://epubs.surrey.ac.uk/id/eprint/845449

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