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Review
. 2023 Mar 2;12(5):1981.
doi: 10.3390/jcm12051981.

Adherence to Oral Antidiabetic Drugs in Patients with Type 2 Diabetes: Systematic Review and Meta-Analysis

Eugenia Piragine  1   2 , Davide Petri  3 , Alma Martelli  1 , Vincenzo Calderone  1 , Ersilia Lucenteforte  4
Affiliations
Review

Adherence to Oral Antidiabetic Drugs in Patients with Type 2 Diabetes: Systematic Review and Meta-Analysis

Eugenia Piragine et al. J Clin Med. .

Abstract

Poor adherence to oral antidiabetic drugs (OADs) in patients with type 2 diabetes (T2D) can lead to therapy failure and risk of complications. The aim of this study was to produce an adherence proportion to OADs and estimate the association between good adherence and good glycemic control in patients with T2D. We searched in MEDLINE, Scopus, and CENTRAL databases to find observational studies on therapeutic adherence in OAD users. We calculated the proportion of adherent patients to the total number of participants for each study and pooled study-specific adherence proportions using random effect models with Freeman-Tukey transformation. We also calculated the odds ratio (OR) of having good glycemic control and good adherence and pooled study-specific OR with the generic inverse variance method. A total of 156 studies (10,041,928 patients) were included in the systematic review and meta-analysis. The pooled proportion of adherent patients was 54% (95% confidence interval, CI: 51-58%). We observed a significant association between good glycemic control and good adherence (OR: 1.33; 95% CI: 1.17-1.51). This study demonstrated that adherence to OADs in patients with T2D is sub-optimal. Improving therapeutic adherence through health-promoting programs and prescription of personalized therapies could be an effective strategy to reduce the risk of complications.

Keywords: T2D; compliance; meta-analysis; oral antidiabetic drugs; systematic review; therapeutic adherence; type 2 diabetes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of search.
Figure 2
Figure 2
Pooled proportions of adherent incident patients stratified by length of follow-up. The width of boxes represents the 95% confidence intervals, while the whiskers extend for the 95% prediction intervals.
Figure 3
Figure 3
Boxplot representing the pooled proportions of adherent patients (expressed as a percentage) stratified by therapeutic class. The boxes represent the 95% confidence intervals of the proportions, while the whiskers extend for the 95% prediction interval.
Figure 4
Figure 4
Forest plot with OR and relative confidence intervals for the association between good adherence and good glycemic control (HbA1c < 7.0%). White lines: confidence interval within the square. Black lines: confidence interval crossing the bounds of the square [40,41,88,98,102,105,109,116,120,131,140,149,152,174,173,180].
See this image and copyright information in PMC

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