Evidence map›Paper›PMID 29755756›Full record

ArticleBMJ open diabetes research & care2018

Treatment choice, medication adherence and glycemic efficacy in people with type 2 diabetes: a UK clinical practice database study.

Jason Gordon, Phil McEwan, Iskandar Idris, Marc Evans, Jorge Puelles

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

Article in BMJ open diabetes research & care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 4 pooled it
4.6field-weighted citation impact, top 4% 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

31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 49 citations in OpenAlex.

  1. Pooled it
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  9. Adherence to 5-aminosalicylic acid maintenance treatment in young people with ulcerative colitis: a retrospective cohort study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
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  19. What Next After Metformin in Type 2 Diabetes? Selecting the Right Drug for the Right Patient.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020
    Article
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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

5 authors at 4 institutions in 2 countries.

Jason GordonHealth Economics & Outcomes Research Ltd, Cardiff, UK.ORCID 0000-0001-8635-742X
Phil McEwanHealth Economics & Outcomes Research Ltd, Cardiff, UK.
Iskandar IdrisSchool of Medicine, University of Nottingham, Nottingham, UK.
Marc EvansDiabetes Resource Centre, Llandough Hospital, Cardiff, UK.
Jorge PuellesGlobal Outcomes Research, Takeda Development Centre Europe Ltd, London, UK.
University of Nottingham · GBSwansea University · GBTakeda (United Kingdom) · GBUniversity Hospital Llandough · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveUsing primary care data obtained from the UK Clinical Practice Research Datalink, this retrospective cohort study examined the relationships between medication adherence and clinical outcomes in patients with type 2 diabetes. RESEARCH DESIGN AND

methodsData were extracted for patients treated between 2008 and 2016, and stratified by oral antihyperglycemic agent (OHA) line of therapy (mono, dual or triple therapy). Patients were monitored for up to 365 days; associations between medication possession ratio (MPR) and outcomes at 1 year (glycated hemoglobin A1c (HbA1c), weight and hypoglycemia incidence) were assessed using linear regression modeling and descriptive analyses.

resultsIn total, 33 849 patients were included in the study (n=23 925 OHA monotherapy; n=8406 OHA dual therapy; n=1518 OHA triple therapy). One-year change in HbA1c was greater among adherent (-0.90 to -1.14%; -9.8 to -12.5 mmol/mol) compared with non-adherent patients (-0.49 to -0.69%; -5.4 to -7.5 mmol/mol). On average, adherent patients had higher hypoglycemia event rates than non-adherent patients (rate ratios of 1.24, 1.10 and 2.06 for OHA mono, dual and triple therapy cohorts, respectively) and experienced greater weight change from baseline. A 10% improvement in MPR was associated with -0.09% (-1.0 mmol/mol), -0.09% (-1.0 mmol/mol) and -0.21% (-2.3 mmol/mol) changes in HbA1c for OHA mono, dual and triple therapy cohorts, respectively.

conclusionsFor patients with type 2 diabetes, increasing medication adherence can bring about meaningful improvements in HbA1c control as the requirement for treatment escalation increases. Regimens associated with weight loss and the avoidance of hypoglycemia were generally associated with better medication adherence and improved glycemic control.

Indexed as

clinical outcome(s)medication adherenceOHA (oral Hypoglycemic Agent)type 2 diabetes

Identifiers

PMID29755756
PMCPMC5942418
OpenAlexW2800329054

What OpenQuestion holds

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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.