Missed doses of oral antihyperglycemic medications in US adults with type 2 diabetes mellitus: prevalence and self-reported reasons

Abstract

Background: Adherence to antihyperglycemic medication is thought to be suboptimal, but the proportion of patients missing doses, the number of doses missed, and reasons for missing are not well described. This survey was conducted to estimate the prevalence of and reasons for missed doses of oral antihyperglycemic medications among US adults with type 2 diabetes mellitus, and to explore associations between missed doses and health outcomes.

Methods: The study was a cross-sectional patient survey. Respondents were contacted via a commercial survey panel and completed an on-line questionnaire via the Internet. Respondents provided information about their use of oral antihyperglycemic medications including doses missed in the prior 4 weeks, personal characteristics, and health outcomes. Weights were calculated to project the prevalence to the US adult population with type 2 diabetes mellitus. Outcomes were compared according to number of doses missed in the past 4 weeks using bivariate statistics and generalized linear models.

Results: Approximately 30% of adult patients with type 2 diabetes mellitus reported missing or reducing ≥1 dose of oral antihyperglycemic medication in the prior 4 weeks. Accidental missing was more commonly reported than purposeful skipping, with forgetting the most commonly reported reason. The timing of missed doses suggested respondents had also forgotten about doses missed, so the prevalence of missed doses is likely higher than reported. Outcomes were poorer among those who reported missing three or more doses in the prior 4 weeks.

Conclusions: A substantial number of US adults with type 2 diabetes mellitus miss doses of their oral antihyperglycemic medications.

Keywords:

• Adherence
• Disease management
• Oral
• Quality of life
• Type 2 diabetes

Transparency

Declaration of funding

Funding for the study was provided by Merck & Co.

Declaration of financial/other relationships

J.T.V. and R.L. have disclosed that they are employees of Kantar Health, a company that received funding from Merck to help conduct this study. C.S.W. has disclosed that she is a contractor to Merck & Co. S.R. has disclosed that he is an employee of Merck & Co. and owns stock in the company.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors would like to acknowledge Duncan Brown of Kantar Health for his contribution to the design of the questionnaire and Sara Bodnar for editorial assistance in preparing the manuscript.

Previous presentation

A portion of the results was presented as a poster at the American Diabetes Association 74th Scientific Sessions, San Francisco, USA, 13–17 June 2014.