ArticleBMJ open diabetes research & care2021
Adherence to antidiabetic treatment and impaired hypoglycemia awareness in type 2 diabetes mellitus assessed in Spanish community pharmacies: the ADHIFAC study.
Article in BMJ open diabetes research & care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Hypoglycaemia Risk Prediction Models for Type 2 Diabetes: A Systematic Review and Meta-Analysis.Endocrinology, diabetes & metabolism · 2026Pooled it
- A global systematic overview of socioeconomic factors associated with antidiabetic medication adherence in individuals with type 2 diabetes.Journal of health, population, and nutrition · 2023Pooled it
- Prevalence and contributing factors of impaired awareness of hypoglycemia in patients with type 2 diabetes: a meta-analysis.Acta diabetologica · 2023Pooled it
- Factors associated with treatment compliance among middle-aged patients with type 2 diabetes mellitus in King Abdulaziz University Hospital, Jeddah, Saudi Arabia.Frontiers in clinical diabetes and healthcare · 2026Article
- Review
- Predictive factors of hypoglycemia in type 2 diabetes: a prospective study using machine learning.Scientific reports · 2025Article
- Motivating Self-Care and Enhancing Treatment Adherence in Elderly Type 2 Diabetes: An Extended Parallel Process Model Intervention.Nursing research and practice · 2025Article
- [Validation of the JH-SEFAC Questionnaire on Knowledge on Insulin Management by Patients with Diabetes in Community Pharmacies].Farmaceuticos comunitarios · 2024Observational
- Long-Term Sulfonylurea Use and Impaired Awareness of Hypoglycemia Among Patients With Type 2 Diabetes in Taiwan.Annals of family medicine · 2024Article
- Non-adherence to non-insulin glucose-lowering drugs: Prevalence, predictors and impact on glycemic control and insulin initiation. A longitudinal cohort study in a large primary care database in Spain.The European journal of general practice · 2023Article
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8 authors at 3 institutions in 1 country.
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Abstract
introductionAdherence to treatment and hypoglycemia awareness are strongly linked to glycemic control and hypoglycemia risk in people with type 2 diabetes mellitus (T2DM). Community pharmacies are suitable facilities to detect these conditions, and should be involved in the strategies to minimize the associated risks and burden. RESEARCH DESIGN AND
methodsThis cross-sectional study conducted at community pharmacies across Spain assessed the prevalence of low adherence to antidiabetic treatments, the frequency of impaired hypoglycemia awareness, and their predictive factors. Adherence was measured with the 8-item Morisky Medication Adherence Scale (MMAS-8) and electronic records of dispensed treatments. The Clarke questionnaire was used to assess impaired hypoglycemia awareness. Healthcare counseling provided in the pharmacy was collected.
resultsSeventy-nine pharmacists and 618 subjects with T2DM participated in the study. Mean age in the overall T2DM population was 67 years, being the majority (69%) pensioners. Adherence was high in 41% of participants, medium in 35%, and low in 24% according to the MMAS-8. Impaired hypoglycemia awareness was observed in 25% of participants. Main determinants of low adherence were the level of education, the number of treatments per patient, hypoglycemia awareness, and the type of pharmacy. Predictive factors of impaired hypoglycemia awareness were the level of education, information on diabetes-related complications, adherence levels, and the type of pharmacy. The proportion of participants who had healthcare counseling was 71% in the overall population and 100% in subjects with impaired hypoglycemia awareness and low adherence. Healthcare counseling comprised diabetes education (69%), pharmacotherapeutic assessment (20%), and physician referrals (11%).
conclusionLack of adherence to antidiabetic treatments and impaired hypoglycemia awareness are frequent and correlate in T2DM. Community pharmacies can detect these conditions and should have an active role in the design of strategies to minimize them.
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