title: Are people with schizophrenia adherent to diabetes medication? A comparative meta-analysis.
abstract: Individuals living with schizophrenia are 2-3 times more likely to experience type 2 diabetes mellitus. Diabetes medication adherence is essential to reduce morbidity and mortality in this population. We conducted a meta-analysis of diabetes medication adherence among people with schizophrenia, and compared this to those without schizophrenia. A systematic search strategy was used to identify all articles reporting adherence to diabetes medications among patients with schizophrenia. In total, 10 unique studies reporting data from 33,910 people with schizophrenia were included. Random effects meta-analysis showed people with schizophrenia adhered to medication on 77.3% of days prescribed (n=32080, 95%CI=73.6-81%, I2=99.2%,), and adhered on 4.6% more days per year than those without schizophrenia (p<0.01, 95%CI=2.4-6.7%, I2=92.5%, schizophrenia n=19367, controls=170,853). Furthermore, 56% of individuals with schizophrenia (n=33680) were considered "adherent" (i.e. >80% adherence over 12-24 month) to diabetes medication, which was significantly more than those without schizophrenia (OR=1.34, 95%CI: 1.18-1.52, p<0.01). Factors which were positively associated with diabetes medication adherence were age, number of outpatient visits, along with multiple medication administration variables. Future prospective research should examine diabetes monitoring, medication prescription, and subsequent adherence in fully representative samples. Novel interventions for maximizing compliance to diabetes medication in this vulnerable population should also be explored.
authors.affiliation: University of Portsmouth, Department of Sport and Exercise Science, Portsmouth, UK PO1 2UP. Electronic address: paul.gorczynski@port.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Gorczynski
authors.affiliation: Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK M13 9PL. Electronic address: joseph.firth@postgrad.manchester.ac.uk.
authors.forename: Joseph
authors.initials: J
authors.lastname: Firth
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK SE5 8AZ; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK WC2R 2LS. Electronic address: brendon.stubbs@kcl.ac.uk.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney 2052 Australia. Electronic address: s.rosenbaum@unsw.edu.au.
authors.forename: Simon
authors.initials: S
authors.lastname: Rosenbaum
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences, 3000 Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, 3000 Leuven-Kortenberg, Belgium. Electronic address: davy.vancampfort@upckuleuven.be.
authors.forename: Davy
authors.initials: D
authors.lastname: Vancampfort
mesh_terms: D000367:Age Factors; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D055118:Medication Adherence / Q000523:psychology*; D011446:Prospective Studies; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology
chemical_list: D007004:Hypoglycemic Agents
keywords: Medication adherence; Meta analysis; Schizophrenia; Type 2 diabetes mellitus