Skip to main content

Advertisement

SpringerLink
Log in

The association between the measurement of adherence to anti-diabetes medicine and the HbA1c

  • Review Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Adherence to medicines is important in subjects with diabetes, as nonadherence is associated with an increased risk of morbidity and mortality. However, it is not clear whether there is an association between adherence to medicines and glycaemic control, as not all studies have shown this. One of the reasons for this discrepancy may be that, although there is a standard measure of glycaemic control i.e. HbA1c, there is no standard measure of adherence to medicines. Adherence to medicines can be measured either qualitatively by Morisky or non-Morisky methods or quantitatively using the medicines possession ratio (MPR). Aims of the review The aims of this literature review are (1) to determine whether there is an association between adherence to anti-diabetes medicines and glycaemic control, and (2) whether any such association is dependent on how adherence is measured. Methods A literature search of Medline, CINAHL and the Internet (Google) was undertaken with search terms; ‘diabetes’ with ‘adherence’ (or compliance, concordance, persistence, continuation) with ‘HbA1c’ (or glycaemic control). Results Twenty-three studies were included; 10 qualitative and 12 quantitative studies, and one study using both methods. For the qualitative methods measurements of adherence to anti-diabetes medicines (non-Morisky and Morisky), eight out of ten studies show an association with HbA1c. Nine of ten studies using the quantitative MPR, and two studies using MPR for insulin only, have also shown an association between adherence to anti-diabetes medicines and HbA1c. However, the one study that used both Morisky and MPR did not show an association. Three of the four studies that did not show a relationship, did not use a range of HbA1c values in their regression analysis. The other study that did not show a relationship was specifically in a low income population. Conclusions Most studies show an association between adherence to anti-diabetes medicines and HbA1c levels, and this seems to be independent of method used to measure adherence. However, to show an association it is necessary to have a range of HbA1c values. Also, the association is not always apparent in low income populations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Stratton IM, Adler AI, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405–12.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Selvin E, Ning Y, Steffes MW, Bash LD, Klein R, Wong TY, Astor BC, Sharrett AR, Brancati FL, Coresh J. Glycated hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes. Diabetes. 2011;60(1):298–305.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Rogvi S, Tapager I, Almdal P, Schiøtz ML, Willaing I. Patient factors and glycaemic control—associations and explanatory power. Diabet Med. 2012;29(10):e382–9.

    Article  CAS  PubMed  Google Scholar 

  4. Morris AD, Boyle DI, McMahon AD, Greene SA, MacDonald TM, Newton RW. Adherence to insulin treatment, glycaemic control, and insulin-dependent diabetes mellitus. The DARTS/MEMO Collaboration. Diabetes audit and research in Tayside Scotland, medicines monitoring unit. Lancet. 1997;350(9090):1505–10.

    Article  CAS  PubMed  Google Scholar 

  5. Bakrishnan R, Rajagopalan R, Camacho FT, Huston SA, Murray FT, Anderson RT. Predictors of medication adherence and associated health care costs in an older population with type 2 diabetes mellitus: a longitudinal cohort study. Clin Ther. 2003;25(11):2958–71.

    Article  Google Scholar 

  6. Lau DT, Nau DP. Oral antihyperglycemic medication nonadherence and subsequent hospitalization among individuals with type 2 diabetes. Diabetes Care. 2004;27(9):2149–53.

    Article  CAS  PubMed  Google Scholar 

  7. Ho PM, Rumsfield JS, Masoudi FA, McClure DL, Plomondon ME, Steiner JF, Magid DJ. Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med. 2006;166(17):1836–41.

    Article  PubMed  Google Scholar 

  8. Hepke KL, Martus MT, Share DA. Costs and utilization associated with pharmaceutical adherence in a diabetic population. Am J Manag Care. 2004;10(2 Pt 2):144–51.

    PubMed  Google Scholar 

  9. Kindmalm L, Melander A, Nilsson JL. Refill adherence of antihyperglycaemic drugs related to glucose control (HbA1c) in patients with type 2 diabetes. Acta Diabetol. 2007;44(4):209–13.

    Article  CAS  PubMed  Google Scholar 

  10. Odegard PS, Gray SL. Barriers to medication adherence in poorly controlled diabetes mellitus. Diabetes Educ. 2008;34(4):692–7.

    Article  PubMed  Google Scholar 

  11. Bains SS, Egede LE. Associations between health literacy, diabetes knowledge, self-care behaviors, and glycemic control in a low income population with type 2 diabetes. Diabetes Technol Ther. 2011;13(3):335–41.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Cohen HW, Shmukler C, Ullman R, Rivera CM, Walker EA. Measurements of medication adherence in diabetic patients with poorly controlled HbA1c. Diabetic Med. 2010;27:210–6.

    Article  CAS  PubMed  Google Scholar 

  13. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67–74.

    Article  CAS  PubMed  Google Scholar 

  14. Coons SJ, Sheahan SL, Martin SS, Hendricks J, Robbins CA, Johnson JA. Predictors of medication noncompliance in a sample of older adults. Clin Ther. 1994;16:110–7.

    CAS  PubMed  Google Scholar 

  15. Van De Steeg N, Sielk M, Pentzek M, Bakx C, Altiner A. Drug-adherence questionnaires not valid for patients taking blood-pressure-lowering drugs in a primary health care setting. J Eval Clin Pract. 2009;15:468–72.

    Article  PubMed  Google Scholar 

  16. Shalansky SJ, Levy A, Ignaszewski AP. Self-reported Morisky score for identifying nonadherence with cardiovascular medications. Ann Pharmacotherap. 2004;38:1363–8.

    Article  Google Scholar 

  17. Koschack J, Marx G, Schnakenberg J, Kochen MM, Himmel W. Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties. J Clin Epidemiol. 2010;63:299–306.

    Article  PubMed  Google Scholar 

  18. Andrade SE, Kahler KH, Frech F, Chang KA. Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidemiol Drug Saf. 2006;15(8):565–74.

    Article  PubMed  Google Scholar 

  19. Kadmon PM, Gruppuso PA. Glycemic control with metformin or insulin therapy in adolescents with type 2 diabetes mellitus. J Pediatr Endocrinol Metab. 2004;17(9):1185–93.

    Article  CAS  PubMed  Google Scholar 

  20. Rhee MK, Slocum W, Ziemer DC, Culler SD, Cook CB, El-Kebbi IM, Gallina DL, Barnes C, Phillips LS. Patient adherence improves glycemic control. Diabetes Educ. 2005;31(2):240–50.

    Article  PubMed  Google Scholar 

  21. Heisler M, Faul JD, Hayward RA, Langa KM, Blaum C, Weir D. Mechanisms for racial and ethnic disparities in glycemic control in middle-aged and older Americans in the health and retirement study. Arch Intern Med. 2007;167(17):1853–60.

    Article  PubMed  Google Scholar 

  22. Mashitani T, Hayashino Y, Okamura S, Kitatani M, Furuya M, Furuya M, Matsunaga K, Kuwata H, Tsuji S, Isi H. Patient-reported adherence to insulin regiment is associated with glycemic control among Japanese patients with type 2 diabetes: Diabetes Distress and Care Registry at Tenri (DDCRT 3). Diabetes Res Clin Pract. 2013;100(2):189–94.

    Article  PubMed  Google Scholar 

  23. Krapek K, King K, Warren SS, George KG, Caputo DA, Mihelich K, Holst EM, Nichol M, Shi SG, Livengood KB, Walden S, Lubowski T. Medication adherence and associated hemoglobin A1c in type 2 diabetes. Ann Pharmacother. 2004;38(9):1357–62.

    Article  CAS  PubMed  Google Scholar 

  24. Hill-Briggs F, Gary TL, Bone LR, Hill MN, Levine DM, Brancati FL. Medication adherence and diabetes control in urban African Americans with type 2 diabetes. Health Psychol. 2005;24(4):349–57.

    Article  PubMed  Google Scholar 

  25. Al-Qazaz H, Sulaiman SA, Hassali MA, Shafie AA, Sundram S, Al-Nuri R, Saleem F. Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes. Int J Clin Pharm. 2011;33(6):1028–35.

    Article  PubMed  Google Scholar 

  26. Wang Y, Lee J, Toh MPSH, Tang WE, Ko Y. Validity and reliability of a self-reported measure of medication adherence in patients with type 2 diabetes mellitus in Singapore. Diabet Med. 2012;29:e338–44.

    Article  CAS  PubMed  Google Scholar 

  27. Aikens JE, Piette JD. Longitudinal association between medication adherence and glycaemic control in type 2 diabetes. Diabet Med. 2013;30(3):338–44.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Schectman JM, Nadkarni MM, Voss JD. The association between diabetes metabolic control and drug adherence in an indigent population. Diabetes Care. 2002;25(6):1015–21.

    Article  PubMed  Google Scholar 

  29. Pladevall M, Williams LK, Potts LA, Divine G, Xi H, Lafata JE. Clinical outcomes and adherence to medications measured by claims data in patients with diabetes. Diabetes Care. 2004;27(12):2800–5.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Lawrence DB, Ragucci KR, Long LB, Parris BS, Helfer LA. Relationship of oral antihyperglycemic (sulfonylurea or metformin) medication adherence and hemoglobin A1c goal attainment for HMO patients enrolled in a diabetes disease management program. J Manag Care Pharm. 2006;12(6):466–71.

    PubMed  Google Scholar 

  31. Rozenfeld Y, Hunt JS, Plauschinat C, Wong KS. Oral antidiabetic medication adherence and glycemic control in managed care. Am J Manag Care. 2008;14(2):71–5.

    PubMed  Google Scholar 

  32. Adams AS, Trinacty CM, Zhang F, Kleinman K, Grant RW, Meigs JB, Soumerai SB, Ross-Degnan D. Medication adherence and racial differences in A1C control. Diabetes Care. 2008;31(5):916–21.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Horswell RL, Wascom CK, Cerise FP, Besse JA, Johnson JK. Diabetes mellitus medication assistance program: relationship of effectiveness to adherence. J Health Care Poor Underserved. 2008;19(3):677–86.

    Article  PubMed  Google Scholar 

  34. Kim N, Agostini JV, Justice AC. Refill adherence to oral hypoglycemic agents and glycemic control in veterans. Ann Pharmacother. 2010;44(5):800–8.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Zhu VJ, Tu W, Marrero DG, Rosenman MR, Overhage JM. Race and medication adherence and glycemic control: findings from an operational health information exchange.In AMIA Annual Symposium Proceedings 2011;1649–57.

  36. Donnelly LA, Morris AD, Evans JM. DARTS/MEMO collaboration. Adherence to insulin and its association with glycemic control in patients with type 2 diabetes. QJM. 2007;100(6):345–50.

    Article  CAS  PubMed  Google Scholar 

  37. Cramer JA, Pugh MJ. The influence of insulin use on glycemic control: how well do adults follow prescriptions for insulin? Diabetes Care. 2005;28(1):78–83.

    Article  PubMed  Google Scholar 

  38. Piette JD, Wagner TH, Potter MB, Schillinger D. Health insurance status, cost-related medication underuse, and outcomes among diabetes patients in three systems of care. Med Care. 2004;42(2):102–9.

    Article  PubMed  Google Scholar 

  39. Ngo-Metzger Q, Sorkin DH, Billimek J, Greenfield S, Kaplan SH. The effects of financial pressures on adherence and glucose control among racial/ethnically diverse patients with diabetes. J Gen Intern Med. 2012;27(4):432–7.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Funding

None.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia

    Sheila A. Doggrell & Servane Warot

Authors
  1. Sheila A. Doggrell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Servane Warot
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sheila A. Doggrell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Doggrell, S.A., Warot, S. The association between the measurement of adherence to anti-diabetes medicine and the HbA1c. Int J Clin Pharm 36, 488–497 (2014). https://doi.org/10.1007/s11096-014-9929-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-014-9929-6

Keywords

Search

Navigation