Adherence to antihyperglycemic medications and glucagon-like peptide 1-receptor agonists in type 2 diabetes: clinical consequences and strategies for improvement - PubMed (original) (raw)

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Adherence to antihyperglycemic medications and glucagon-like peptide 1-receptor agonists in type 2 diabetes: clinical consequences and strategies for improvement

Francesco Giorgino et al. Patient Prefer Adherence. 2018.

Abstract

Adherence to antihyperglycemic medications is often suboptimal in patients with type 2 diabetes, and this can contribute to poor glycemic control, increased hospitalization, and the development of diabetic complications. Reported adherence rates to antihyperglycemics vary widely among studies, and this may be related to differences in methodology for measuring adherence, patient populations, and other factors. Poor adherence may occur regardless of the specific regimen used and whether therapy is oral or injectable, and can be especially common in chronic, asymptomatic conditions, such as type 2 diabetes. More convenient drug-administration regimens and advances in formulations and delivery devices are among strategies shown to improve adherence to antihyperglycemic therapy, especially for injectable therapy. This is exemplified by technological developments made in the drug class of glucagon-like peptide 1-receptor agonists, which are a focus of this narrative review. Dulaglutide, albiglutide, and prolonged-release exenatide have an extended duration of action and can be administered once weekly, whereas such agents as liraglutide require once-daily administration. The convenience of once-weekly versus once-daily administration is associated with better adherence in real-world studies involving this class of agent. Moreover, provision of a user-friendly delivery device has been shown to overcome initial resistance to injectable therapy among patients with type 2 diabetes. This suggests that recent innovations in drug formulation (eg, ready-to-use formulations) and delivery systems (eg, single-dose prefilled pens and hidden, ready-attached needles) may be instrumental in encouraging patient acceptance. For physicians who aim to improve their patients' adherence to antihyperglycemic medications, it is thus important to consider the patient's therapeutic experience (treatment frequency, drug formulation, delivery device). Better adherence, powered by recent technological advances in the delivery of glucagon-like peptide 1-receptor agonists, may thus lead to improved clinical outcomes in type 2 diabetes.

Keywords: adherence; compliance; glucagon-like peptide 1-receptor agonists; type 2 diabetes mellitus.

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Conflict of interest statement

Disclosure Francesco Giorgino discloses: Advisory Boards: AstraZeneca/BMS, Eli Lilly, Roche Diagnostics, and Takeda. Consultant: AstraZeneca/BMS, Boehringer Ingelheim, Lifescan, Merck Sharp & Dohme, Novo Nordisk, and Sanofi Research. Support: AstraZeneca/BMS, Eli Lilly Lifescan, Sanofi, and Takeda. Valeria Pechtner, Raffaella Gentilella and Antonella Corcos are employees and stockholders of Eli Lilly and Company. Alfred Penfornis discloses congress invitations, honoraria and consultancies from Abbott and Medtronic. Alfred Penfornis has received fees for consultancy, advisory boards, speaking, travel or accommodation from Ascencia, LifeScan, Sanofi, Lilly, Novartis, MSD, AstraZeneca, Abbott, Novo Nordisk and Medtronic. The authors report no other conflicts of interest in this work.

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References

    1. International Diabetes Federation . IDF Diabetes Atlas. 7th ed. Brussels: IDF; 2015.
    1. Cheung BM, Ong KL, Cherny SS, Sham PC, Tso AW, Lam KS. Diabetes prevalence and therapeutic target achievement in the United States, 1999 to 2006. Am J Med. 2009;122(5):443–453. - PubMed
    1. Guo XH. The value of short-and long-acting glucagon-like peptide-1 agonists in the management of type 2 diabetes mellitus: experience with exenatide. Curr Med Res Opin. 2016;32(1):61–76. - PubMed
    1. World Health Organization . Adherence to Long-Term Therapies: Evidence for Action. Geneva: WHO; 2003.
    1. Asche C, LaFleur J, Conner C. A review of diabetes treatment adherence and the association with clinical and economic outcomes. Clin Ther. 2011;33(1):74–109. - PubMed

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