Monitoring safety and use of old and new treatment options for type 2 diabetic patients: a two-year (2013–2016) analysis

ABSTRACT

Objective: To compare patients’ and physicians’ perceptions regarding effectiveness and tolerability of non-insulin hypoglycemic drugs in a cohort of type 2 diabetic patients; to verify whether a possible tridimensional link between effectiveness, tolerability, and adherence affects long-term therapeutic outcomes.

Methods: A two-year observational study was performed in 1389 Type 2 diabetic patients by involving general practitioner clinics and Diabetes Centers. A decimal scale and the Morisky questionnaire were used, respectively, to assess effectiveness and tolerability perceptions, and medication adherence.

Results: Physicians perceived therapy as more efficacious compared to their patients: perceived effectiveness was steady for physicians during the study whereas patients’ perception not significantly decreased (mean score from >8 to 7.84 ± 1.69). Physicians assigned higher tolerability scores compared to patients but only at the beginning of the study; interestingly, physicians’ tolerability perception was poorer than patients’ perception at last follow-up (mean score = 7.57 ± 1.40 vs. 7.88 ± 1.84). Favorable (score >7) patients’ perceptions about treatment effectiveness and tolerability were associated with higher adherence. Patients showed medium adherence across the study.

Conclusions: A mutual relationship between clinical effectiveness, adverse drug reactions, and adherence has been established, significantly impacting the clinical management of diabetic patients. A careful monitoring of this link by clinicians appears therefore necessary.

KEYWORDS:

• Adverse drug reactions
• clinical effectiveness
• medication adherence
• Morisky scale
• non-insulin hypoglycemic drugs
• type 2 diabetes mellitus

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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Additional information

Funding

This paper is part of a supplemental issue funded by the Second University of Naples.