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Nonadherence in type 2 diabetes: practical considerations for interpreting the literature

Authors Blackburn D, Swidrovich J, Lemstra M

Received 22 December 2012

Accepted for publication 29 January 2013

Published 3 March 2013 Volume 2013:7 Pages 183—189


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

David F Blackburn,1 Jaris Swidrovich,2 Mark Lemstra1

1College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, 2Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada

Abstract: The rising prevalence of type 2 diabetes poses a serious threat to human health and the viability of many health care systems around the world. Although several prescription medications can play a vital role in controlling symptoms and preventing complications, non-adherence to these therapies is highly prevalent and has been linked to increases in morbidity, mortality, and health care costs. Although a vast array of significant adherence predictors has been identified, the ability to explain or predict non-adherence with known risk-factors remains poor. Further, the definitions, outcomes, and various measures used in the non-adherence literature can be misleading for the unfamiliar reviewer. In this narrative review, a practical overview of important considerations for interpreting adherence endpoints and measures is discussed. Also, an organizational framework is proposed to consider published adherence interventions. This framework may allow for a unique appreciation into areas of limited knowledge and thus highlights targets for future research.

Keywords: medication adherence, compliance, type 2 diabetes, adherence interventions

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