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Cited by 161Medication Adherence and ComplianceDiabetes Management and EducationDiabetes Treatment and Management

Adherence to Preventive Medications

Open access
Walker, Elizabeth A., Molitch, Mark, Kramer, M. Kaye, Kahn, Steven, Ma, Yong, Edelstein, Sharon, Smith, Kellie, Johnson, Mariana Kiefer +3 more·2006·Diabetes Care
DOI 10.2337/dc06-0454PMC PMC1762037
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Abstract

OBJECTIVE—To evaluate barriers to and strategies for medication adherence and predictors of adherence and the primary outcome in the Diabetes Prevention Program (DPP). RESEARCH DESIGN AND METHODS—Within a randomized, controlled primary prevention study for type 2 diabetes, we collected data on study medication adherence, its predictors, and health outcomes in 27 clinical centers across mainland U.S. and Hawaii. Medication arm participants included 2,155 adults with impaired glucose tolerance randomly assigned to either metformin or matched placebo treatment arms. Structured interviews were used to promote medication adherence and to collect data regarding adherence. Adherence was measured by pill count. The primary DPP outcome of type 2 diabetes was assessed by fasting plasma glucose and oral glucose tolerance test. RESULTS—Older age-groups were more adherent than the youngest group (P = 0.01) in the metformin group. The most frequently reported barrier to adherence was “forgetting” (22%). Women reported more adverse effects of metformin (15 vs. 10%, P = 0.002) in the metformin group. Odds of nonadherence increased as participants reported more than one barrier (odds ratio 19.1, P < 0.001). Odds of adherence increased as participants reported multiple strategies to take medication (2.69, P < 0.0001). There was a 38.2% risk reduction for developing diabetes for those adherent to metformin compared with those adherent to placebo (P < 0.0003). CONCLUSIONS—DPP medication adherence results are unique in primary prevention for a chronic disease in a large multiethnic sample. Our finding that adherence was associated with risk reduction for diabetes supports the development of brief interventions in clinical settings where medication adherence is a challenge.

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Authors
Walker, E. A., Molitch, M., Kramer, M. K., Kahn, S., Ma, Y., Edelstein, S., Smith, K., Johnson, M. K., Kitabchi, A., Crandall, J., & for the Diabetes Prevention Program Research Group
Affiliations
  • Albert Einstein College of Medicine (US)
  • Northwestern University (US)
  • University of Pittsburgh (US)
  • University of Washington (US)
  • George Washington University (US)
  • Thomas Jefferson University (US)
  • University of Memphis (US)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2006-09-01
Volume
29
Issue
9
Pages
1997-2002
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc06-0454
PMC
PMC1762037
OpenAlex
W2159611971
Cited by
161
References
7
Citations by year
2026: 4 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 3 · 2021: 7 · 2020: 9 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 8 · 2015: 10 · 2014: 11 · 2013: 12 · 2012: 9
FWCI
7.24
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • American Diabetes Association
  • Bristol-Myers Squibb
  • Henry M. Jackson Foundation
  • National Institutes of Health
  • Centers for Disease Control and Prevention
  • National Institute on Aging
  • National Institute of Diabetes and Digestive and Kidney Diseases (U01DK048489)
  • National Institute of Child Health and Human Development
  • National Center for Research Resources
  • National Institute on Minority Health and Health Disparities
  • Office of Women's Health
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
medication adherence, metformin, type 2 diabetes prevention, impaired glucose tolerance, barriers to adherence, adherence strategies, predictors of adherence, adverse drug reactions, primary prevention, brief intervention, age differences in adherence, sex differences in adherence
MeSH terms
Adult, Aged, Aged, 80 and over, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Humans, Hypoglycemic Agents, Male, Metformin, Middle Aged, Patient Compliance, Prognosis, Logistic Models, Odds Ratio, Treatment Outcome

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