PMID- 20203462
OWN - NLM
STAT- MEDLINE
DCOM- 20100401
LR  - 20151119
IS  - 1941-9260 (Electronic)
IS  - 0032-5481 (Linking)
VI  - 122
IP  - 2
DP  - 2010 Mar
TI  - Impact of metformin-induced gastrointestinal symptoms on quality of life and 
      adherence in patients with type 2 diabetes.
PG  - 112-20
LID - 10.3810/pgm.2010.03.2128 [doi]
AB  - AIMS: Gastrointestinal (GI) symptoms are common in patients with type 2 diabetes 
      mellitus (T2DM). This study assesses the impact of 1) metformin on GI symptoms 
      and health-related quality of life (HRQoL) and 2) metformin-associated GI 
      symptoms on medication adherence in patients with type 2 diabetes newly beginning 
      therapy. METHODS: Patients with T2DM aged>or=18 years starting metformin from 
      January to June 2007 who filled their prescriptions for >or=3 months were 
      identified from a health benefits company database. Via telephone, GI symptom 
      impact was evaluated in a 360-patient sample using the validated Bowel Symptom 
      Questionnaire and Medical Outcomes Study 36-Item Short-Form Health (SF-36) 
      survey. Adherence was assessed using the medication possession ratio (MPR). 
      Logistic regression adjusting for demographic and clinical covariates was used to 
      assess the relationship between GI symptoms and MPR<80%. RESULTS: The most and 
      least common GI symptoms reported were diarrhea (62.1%) and retching (21.1%), 
      respectively. Most GI symptoms were associated with lower physical and mental 
      HRQoL (P<0.05). Most changes in specific HRQoL reached the minimum important 
      difference of 3 points. Bloating, nausea, and abdominal pain were significantly 
      associated with MPR<80%. Adjustment for demographic, clinical, and HRQoL factors 
      made these relationships less evident. CONCLUSIONS: Metformin-associated GI 
      symptoms in patients with T2DM lead to lower physical and mental HRQoL, which may 
      result in patient nonadherence or physician reluctance to optimally titrate the 
      metformin dose.
FAU - Florez, Hermes
AU  - Florez H
AD  - University of Miami-Humana Health Service Research Center, Miami, FL 33125, USA. 
      hflorez@med.miami.edu
FAU - Luo, Jiacong
AU  - Luo J
FAU - Castillo-Florez, Sumaya
AU  - Castillo-Florez S
FAU - Mitsi, Georgia
AU  - Mitsi G
FAU - Hanna, John
AU  - Hanna J
FAU - Tamariz, Leonardo
AU  - Tamariz L
FAU - Palacio, Ana
AU  - Palacio A
FAU - Nagendran, Sukumar
AU  - Nagendran S
FAU - Hagan, Michael
AU  - Hagan M
LA  - eng
PT  - Journal Article
PL  - England
TA  - Postgrad Med
JT  - Postgraduate medicine
JID - 0401147
RN  - 0 (Hypoglycemic Agents)
RN  - 9100L32L2N (Metformin)
SB  - IM
MH  - Aged
MH  - Confidence Intervals
MH  - Data Collection
MH  - Diabetes Mellitus, Type 2/*drug therapy/psychology
MH  - Female
MH  - Gastrointestinal Diseases/*chemically induced/psychology
MH  - Health Status Indicators
MH  - Humans
MH  - Hypoglycemic Agents/*adverse effects/therapeutic use
MH  - Logistic Models
MH  - Male
MH  - Medication Adherence/psychology/*statistics & numerical data
MH  - Metformin/*adverse effects/therapeutic use
MH  - Odds Ratio
MH  - Psychometrics
MH  - *Quality of Life
MH  - Risk Factors
MH  - Surveys and Questionnaires
MH  - United States
EDAT- 2010/03/06 06:00
MHDA- 2010/04/02 06:00
CRDT- 2010/03/06 06:00
PHST- 2010/03/06 06:00 [entrez]
PHST- 2010/03/06 06:00 [pubmed]
PHST- 2010/04/02 06:00 [medline]
AID - 10.3810/pgm.2010.03.2128 [doi]
PST - ppublish
SO  - Postgrad Med. 2010 Mar;122(2):112-20. doi: 10.3810/pgm.2010.03.2128.