PMID- 31340969
OWN - NLM
STAT- MEDLINE
DCOM- 20200723
LR  - 20200723
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 9
IP  - 7
DP  - 2019 Jul 23
TI  - Oral antidiabetic medication adherence and glycaemic control among patients with 
      type 2 diabetes mellitus: a cross-sectional retrospective study in a tertiary 
      hospital in Saudi Arabia.
PG  - e029280
LID - 10.1136/bmjopen-2019-029280 [doi]
LID - e029280
AB  - OBJECTIVES: The purpose of this study is to measure the adherence rates of oral 
      antidiabetic drugs (OADs) in patients with type 2 diabetes mellitus (T2DM) and 
      assess the relationship of glycaemic control and adherence to OADs after 
      controlling for other associated factors. DESIGN: Cross-sectional retrospective 
      study. SETTING: Large tertiary hospital in the central region of Saudi Arabia. 
      PARTICIPANTS: 5457patients aged 18 years and older diagnosed with T2DM during the 
      period from 1 January 2016 to 31 December 2016. PRIMARY AND SECONDARY OUTCOME 
      MEASURES: The modified medication possession ratio (mMPR) was calculated as a 
      proxy measure for adherence of OADs. The factors associated with OADs 
      non-adherence and medication oversupply were assessed using multinomial logistic 
      regression models. The secondary outcomes were to measure the association between 
      OADs adherence and glycaemic control. RESULTS: Majority of patients with T2DM 
      were females (n=3400, 62.3%). The average glycated haemoglobin was 8.2+/-1.67. 
      Among the study population, 48.6% had good adherence (mMPR >0.8) and 8.6% had a 
      medication oversupply (mMPR >1.2). Good adherence was highest among those using 
      repaglinide (71.0%) followed by pioglitazone (65.0%) and sitagliptin (59.0%). In 
      the multivariate analysis, women with T2DM were more likely to have poor 
      adherence (adjusted OR (AOR)=0.76, 95% CI=0.67, 0.86) compared with men. Also, 
      medication oversupply was more likely among patients with hyperpolypharmacy 
      (AOR=1.88, 95% CI=1.36, 2.63), comorbid osteoarthritis (AOR=1.72, 95% CI=1.20, 
      02.45) and non-Saudi patients (AOR=1.53, 95% CI=1.16, 2.01). However, no 
      association was found between glycaemic control and adherence to OADs. 
      CONCLUSION: The study findings support the growing concern of non-adherence to 
      OADs among patients with T2DM in Saudi Arabia. Decision makers have to invest in 
      behavioural interventions that will boost medication adherence rates. This is 
      particularly important in patients with polypharmacy and high burden of comorbid 
      conditions.
CI  - (c) Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Balkhi, Bander
AU  - Balkhi B
AD  - Department of Clinical Pharmacy, College of Pharmacy, King Saud University, 
      Riyadh, Saudi Arabia.
FAU - Alwhaibi, Monira
AU  - Alwhaibi M
AUID- ORCID: 0000-0003-3707-0582
AD  - Department of Clinical Pharmacy, College of Pharmacy, King Saud University, 
      Riyadh, Saudi Arabia.
FAU - Alqahtani, Nasser
AU  - Alqahtani N
AD  - Drug Sector, Saudi Food and Drug Authority, Riyadh, Riyadh, Saudi Arabia.
FAU - Alhawassi, Tariq
AU  - Alhawassi T
AD  - Department of Clinical Pharmacy, College of Pharmacy, King Saud University, 
      Riyadh, Saudi Arabia.
AD  - Medication Safety Research Chair, College of Pharmacy, King Saud University, 
      Riyadh, Saudi Arabia.
FAU - Alshammari, Thamir M
AU  - Alshammari TM
AD  - Medication Safety Research Chair, College of Pharmacy, King Saud University, 
      Riyadh, Saudi Arabia.
AD  - Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, 
      Saudi Arabia.
FAU - Mahmoud, Mansour
AU  - Mahmoud M
AD  - Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah 
      University, Madinah, Saudi Arabia.
FAU - Almetwazi, Mansour
AU  - Almetwazi M
AD  - Department of Clinical Pharmacy, College of Pharmacy, King Saud University, 
      Riyadh, Saudi Arabia.
FAU - Ata, Sondus
AU  - Ata S
AD  - Investigational Drugs and Research Unit, King Khalid University Hospital, Riyadh, 
      Saudi Arabia.
FAU - Kamal, Khalid M
AU  - Kamal KM
AD  - Division of Pharmaceutical, Administrative and Social Sciences, Duquesne 
      University School of Pharmacy, Pittsburgh, USA.
LA  - eng
PT  - Journal Article
DEP - 20190723
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Administration, Oral
MH  - Adolescent
MH  - Adult
MH  - Blood Glucose/*analysis
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/*blood/*drug therapy
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/*administration & dosage
MH  - Male
MH  - Medication Adherence/*statistics & numerical data
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Saudi Arabia
MH  - Tertiary Care Centers
MH  - Young Adult
PMC - PMC6661664
OTO - NOTNLM
OT  - adherence
OT  - diabetes
OT  - electronic health records (EHR)
OT  - medication possession ratio (MPR)
OT  - oral antidiabetic drugs (OADS)
COIS- Competing interests: None declared.
EDAT- 2019/07/26 06:00
MHDA- 2020/07/24 06:00
PMCR- 2019/07/23
CRDT- 2019/07/26 06:00
PHST- 2019/07/26 06:00 [entrez]
PHST- 2019/07/26 06:00 [pubmed]
PHST- 2020/07/24 06:00 [medline]
PHST- 2019/07/23 00:00 [pmc-release]
AID - bmjopen-2019-029280 [pii]
AID - 10.1136/bmjopen-2019-029280 [doi]
PST - epublish
SO  - BMJ Open. 2019 Jul 23;9(7):e029280. doi: 10.1136/bmjopen-2019-029280.