title: Adherence to hypoglycaemic medication among people with type 2 diabetes in primary care.
abstract: OBJECTIVE
  To assess levels and correlates of adherence to hypoglycaemic medication among patients offered organised general practice diabetes care.
  
  
  METHODS
  60 patients prescribed oral hypoglycaemic medication were recruited to a two-month prospective study. Prescribed doses taken and days on which the prescribed number of doses was taken were measured by MEMS (Medication Event Monitoring System).
  
  
  RESULTS
  Overall 99.1% of prescribed doses were taken (median, IQR: 96.8-100%), this was inversely correlated with daily dose frequency (Spearman's rho=0.37, p=0.004). Only 4 patients (6.7%) took less than 90% of prescribed doses. The prescribed dose was taken on 96.4% of days (median, IQR: 89.1-98.2%), this was correlated with age (rho=0.26, p=0.047) and inversely correlated with HbA(1c) levels (rho=-0.29, p=0.02) and daily dose frequency (rho=-0.33, p=0.009). Adherence to metformin was less than to other hypoglycaemic medication (Z=-3.48, p=0.0005).
  
  
  CONCLUSIONS
  A dispensing practice with a well-run diabetes service can support high rates of adherence to hypoglycaemic medication. Before changing medication, low adherence might be considered as a possible cause of progressive hyperglycaemia, particularly among patients prescribed metformin more than once a day. Selective monitoring with MEMS may have a clinical as well as a research role in such people.
authors.affiliation: The Rookery Medical Centre, Newmarket, Suffolk, United Kingdom.
authors.forename: Anthony J S
authors.initials: AJ
authors.lastname: White
authors.forename: Ian
authors.initials: I
authors.lastname: Kellar
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Prevost
authors.forename: Ann L
authors.initials: AL
authors.lastname: Kinmonth
authors.forename: Stephan
authors.initials: S
authors.lastname: Sutton
authors.forename: Melissa
authors.initials: M
authors.lastname: Canny
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Griffin
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D048909:Diabetes Complications / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013453:Sulfonylurea Compounds / Q000008:administration & dosage*; D016903:Drug Monitoring
chemical_list: D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D008687:Metformin