Evidence map›Paper›PMID 32461914›Full record

ArticleJournal of clinical & translational endocrinology2020

Metformin adherence and discontinuation among patients with type 2 diabetes: A retrospective cohort study.

Yuexin Tang, Tracey Weiss, Jinan Liu, Swapnil Rajpathak, Kamlesh Khunti

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical & translational endocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 15% 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

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.

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  15. Mechanism of the antidiabetic action ofFrontiers in nutrition · 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

5 authors at 2 institutions in 2 countries.

Yuexin TangMerck & Co., Inc., Kenilworth, NJ, USA.
Tracey WeissMerck & Co., Inc., Kenilworth, NJ, USA.
Jinan LiuMerck & Co., Inc., Kenilworth, NJ, USA.
Swapnil RajpathakMerck & Co., Inc., Kenilworth, NJ, USA.
Kamlesh KhuntiUniversity of Leicester, Diabetes Research Centre, Leicester, UK.
Merck & Co., Inc., Rahway, NJ, USA (United States) · USUniversity of Leicester · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo describe discontinuation and adherence to metformin in the United Kingdom.

methodsThis was a retrospective analysis of data from the Clinical Practice Research Datalink database of type 2 diabetes patients aged ≥18 years with ≥1 metformin prescription in 2013. Metformin use was assessed in new and ongoing users, defined, respectively, as not having or having a prescription for metformin in the baseline period. Discontinuation was assessed in all patients and adherence in patients who did not discontinue metformin. Factors predictive of discontinuation and adherence were assessed.

resultsDiscontinuation among new and ongoing users was 35.9% and 23.1%, respectively. Among the continuers of metformin treatment, the adherence rate was 40.5% and 44.3% among new and ongoing users, respectively. Among new users, baseline use of DDP-4 inhibitors (HR 1.276) and diabetes duration (HR 1.013) were associated with an increased risk of discontinuation, whereas increased age (HR 0.997), concomitant lipid-lowering therapy (HR 0.956), macrovascular disease (HR 0.952), and chronic kidney disease (HR 0.952) were associated with a decreased risk of discontinuation among ongoing users. Variables positively associated with adherence in both user groups were (HR values for all patients) age (1.021), smoking status (1.188), and baseline comorbidities: chronic kidney disease, depression, dementia, and chronic obstructive pulmonary disease (1.106, 1.192, 2.27, and 1.211, respectively), while obesity (0.936) and HbA1c 8.0-8.9% (0.862; reference <6.5%) were negatively associated with adherence.

conclusionsAbout one-third of patients initiating metformin discontinued within 12 months and fewer than 50% of all patients are adherent to metformin.

Indexed as

AdherenceBMI, body mass indexCCI, Charlson comorbidity indexCPRD, Clinical Practice Research DatalinkDiscontinuationDrug therapyMetforminMPR, medication possession ratioOral anti-hyperglycemic agentsPDC, proportion-of-days coveredType 2 diabetes mellitusUKPDS, United Kingdom Prospective Diabetes Study

Identifiers

PMID32461914
PMCPMC7240214
OpenAlexW3016954284

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.