A systematic review of adherence with medications for diabetes

Cramer, Joyce A.

doi:10.2337/diacare.27.5.1218

Cited by 1,203Medication Adherence and ComplianceDiabetes Management and EducationDiabetes Management and Research

A systematic review of adherence with medications for diabetes

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Cramer, Joyce A.·2004·Diabetes Care

DOI 10.2337/diacare.27.5.1218

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Abstract

OBJECTIVE—The purpose of this study was to determine the extent to which patients omit doses of medications prescribed for diabetes. RESEARCH DESIGN AND METHODS—A literature search (1966–2003) was performed to identify reports with quantitative data on adherence with oral hypoglycemic agents (OHAs) and insulin and correlations between adherence rates and glycemic control. Adequate documentation of adherence was found in 15 retrospective studies of OHA prescription refill rates, 5 prospective electronic monitoring OHA studies, and 3 retrospective insulin studies. RESULTS—Retrospective analyses showed that adherence to OHA therapy ranged from 36 to 93% in patients remaining on treatment for 6–24 months. Prospective electronic monitoring studies documented that patients took 67–85% of OHA doses as prescribed. Electronic monitoring identified poor compliers for interventions that improved adherence (61–79%; P < 0.05). Young patients filled prescriptions for one-third of prescribed insulin doses. Insulin adherence among patients with type 2 diabetes was 62–64%. CONCLUSIONS—This review confirms that many patients for whom diabetes medication was prescribed were poor compliers with treatment, including both OHAs and insulin. However, electronic monitoring systems were useful in improving adherence for individual patients. Similar electronic monitoring systems for insulin administration could help healthcare providers determine patients needing additional support.

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These adherence rates are lower than the recommended 90% threshold.
“These statistics are unacceptably lower than the recommended 90% threshold [21].”
From Factors influencing long-term medication non-adherence among diabetes and hypertensive patients in Ghana: A qualitative investigation (2018) · cites this paper as [21]

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Authors: Cramer, J. A.
Affiliations: Yale University (US)
Corresponding author: Cramer, Joyce A.
ORCID: Cramer, Joyce A.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2004-05-01
Volume: 27
Issue: 5
Pages: 1218-1224
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.27.5.1218
OpenAlex: W2164733897
Cited by: 1,203
References: 3
Citations by year: 2026: 17 · 2025: 27 · 2024: 37 · 2023: 31 · 2022: 34 · 2021: 58 · 2020: 57 · 2019: 63 · 2018: 56 · 2017: 62 · 2016: 80 · 2015: 83 · 2014: 95 · 2013: 87 · 2012: 78
FWCI: 3.83
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
Funders: Novo Nordisk
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 Management and Research
Keywords: medication adherence, diabetes mellitus, oral antidiabetic drugs, insulin, dose omission, electronic medication monitoring, glycemic control, type 2 diabetes
MeSH terms: Diabetes Mellitus, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Patient Compliance, Retrospective Studies

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A systematic review of adherence with medications for diabetes

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