title: Patient-reported tolerability issues with oral antidiabetic agents: Associations with adherence; treatment satisfaction and health-related quality of life.
abstract: OBJECTIVE
  The study's aim was to quantify prevalence of tolerability issues among patients with T2DM currently treated with OADs and to assess its association with treatment adherence, satisfaction and health-related quality of life (HRQL).
  
  
  METHODS
  Data were collected from the 2006-2008 US National Health and Wellness Survey and the Ailment Panel of Lightspeed Online Research, an internet-based questionnaire. Participants (N=2074) self-reported a diagnosis of T2DM, were >18 years of age and currently taking >1 OADs but not insulin, and spoke English.
  
  
  RESULTS
  The majority (71.7%) experienced at least 1 tolerability issue in the past 2 weeks; 49.7% experienced >2. Tolerability issues included signs/symptoms of hypoglycemia (57.2%), constipation/diarrhea (28%), headaches (25.6%), weight gain (22.9%) and water retention (21.0%). There was a significant association between the number of tolerability issues and both the likelihood of non-adherence (r=0.20, p<0.01) and reduced treatment satisfaction (r=-0.42, p<0.01). Each additional tolerability issue was associated with 28% greater likelihood of medication non-adherence. Constipation/diarrhea (b=-0.02, p<0.01) and symptoms of hypoglycemia (b=-0.08, p<0.01) were significantly associated with lower HRQL scores.
  
  
  CONCLUSIONS
  Optimizing OAD therapy of T2DM by improving tolerability may increase patient satisfaction, medication adherence and HRQL, and may increase the likelihood of attaining treatment goals.
authors.affiliation: AstraZeneca, LP, Wilmington, DE 19850, United States. michael.pollack@astrazeneca.com
authors.forename: Michael F
authors.initials: MF
authors.lastname: Pollack
authors.forename: Fanta W
authors.initials: FW
authors.lastname: Purayidathil
authors.forename: Susan C
authors.initials: SC
authors.lastname: Bolge
authors.forename: Setareh A
authors.initials: SA
authors.lastname: Williams
mesh_terms: D000284:Administration, Oral; D000368:Aged; D003248:Constipation / Q000139:chemically induced; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D003967:Diarrhea / Q000139:chemically induced; D004361:Drug Tolerance / Q000502:physiology*; D005260:Female; D006261:Headache / Q000139:chemically induced; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D020407:Internet; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014481:United States; D015430:Weight Gain / Q000187:drug effects
chemical_list: D007004:Hypoglycemic Agents