Evidence map›Paper›PMID 29302934›Full record

ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2018

A Class Comparison of Medication Persistence in People with Type 2 Diabetes: A Retrospective Observational Study.

Andrew McGovern, William Hinton, Silvio Calderara, Neil Munro, Martin Whyte, Simon de Lusignan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 4 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 46 citations in OpenAlex.

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  13. Inequities in hypertension management: observational cross-sectional study in North East London using electronic health records.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Andrew McGovernSection of Clinical Medicine and Aging, University of Surrey, Guildford, UK. a.mcgovern@surrey.ac.uk.ORCID http://orcid.org/0000-0002-6833-9399
William HintonSection of Clinical Medicine and Aging, University of Surrey, Guildford, UK.
Silvio CalderaraEli Lilly and Company, 1214, Vernier-Geneva, Switzerland.
Neil MunroSection of Clinical Medicine and Aging, University of Surrey, Guildford, UK.
Martin WhyteSection of Clinical Medicine and Aging, University of Surrey, Guildford, UK.
Simon de LusignanSection of Clinical Medicine and Aging, University of Surrey, Guildford, UK.
University of Surrey · GBEli Lilly (Switzerland) · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLonger medication persistence in type 2 diabetes (T2D) is associated with improved glycaemic control. It is not clear which oral therapies have the best persistence. The objective of this study was to compare medication persistence across different oral therapies in people with T2D.

methodsWe performed a retrospective cohort analysis using a primary-care-based population, the Royal College of General Practitioners Research and Surveillance Centre cohort. We identified new prescriptions for oral diabetes medication in people with type 2 diabetes between January 1, 2004 and July 31, 2015. We compared median persistence across each class. We also compared non-persistence (defined as a prescription gap of ≥ 90 days) between classes, adjusting for confounders, using Cox regression. Confounders included: age, gender, ethnicity, socioeconomic status, alcohol use, smoking status, glycaemic control, diabetes duration, diabetes complications, comorbidities, and number of previous and concurrent diabetes medications.

resultsWe identified 60,327 adults with T2D. The majority 42,810 (70.9%) of those had one or more oral medications prescribed; we measured persistence in those patients (who were prescribed 55,728 oral medications in total). Metformin had the longest median persistence (3.04 years; 95% CI 2.94-3.12). The adjusted hazard ratios for non-persistence compared with metformin were: sulfonylureas HR 1.20 (1.16-1.24), DPP-4 inhibitors HR 1.43 (1.38-1.49), thiazolidinediones HR 1.71 (95% CI 1.64-1.77), SGLT2 inhibitors HR 1.04 (0.93-1.17), meglitinides HR 2.25 (1.97-2.58), and alpha-glucosidase inhibitors HR 2.45 (1.98-3.02). The analysis of SGLT2 inhibitors was limited by the short duration of follow-up for this new class. Other factors associated with reduced medication persistence were female gender, younger age, and non-white ethnicity.

conclusionsPersistence is strongly influenced by medication class and should be considered when initiating treatments.

Indexed as

Medication adherenceMedication complianceMedication persistenceType 2 diabetes

Identifiers

PMID29302934
PMCPMC5801247
OpenAlexW2781836119

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.