Adherence to Preventive Medications Reduces Risk of Diabetes

Participants who were compliant had a 38.2% reduced risk of developing diabetes. The DPP investigated the value of intensive lifestyle intervention or metformin in delaying or preventing type 2 diabetes in high-risk individuals with impaired glucose tolerance.

Dr. Elizabeth A. Walker, of George Washington University, Rockville, Maryland, and colleagues examined medication adherence and health outcomes in the metformin and placebo arms of the DPP. They also assessed barriers to adherence and strategies for medication adherence.

A total of 2155 subjects who were randomly assigned to either the metformin or placebo treatment arms were included in the analysis. The overall adherence rates (the proportion of patients taking at least 80% of the prescribed dose) were 71% in the metformin group and 77% in the placebo group.

Among patients taking metformin, older age groups were more adherent than the youngest group (p = 0.01).

"Among both metformin and placebo arms, the most commonly reported barriers to taking DPP medication as prescribed were forgetting to take doses (22%), adverse effects (8%), and disruption of routines (8%)," Dr. Walker’s team found. Overall, 15% of women and 10% of men reported adverse effects in the metformin group.

Participants who reported multiple strategies to take medications had increased odds of adherence (odds ratio 2.69, p < 0.0001).

Compared to patients who were adherent to placebo, those adherent to metformin had a 38.2% reduced risk of developing diabetes (p < 0.0003), the investigators report.

They conclude, "Our finding that the level of medication adherence predicted the primary outcome of diabetes lend support for future development and evaluation of brief, practical medication adherence interventions for primary care settings."

Diabetes Care 2006;29:1997-2002.

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