Abstract
Type 2 diabetes (T2D) affects ∼21 million people in the US. With this high prevalence, and the significance of medication adherence in achieving optimal clinical outcomes, it is worthwhile to discern the rates of medication adherence in the US population with T2D over time. The study objectives were to determine the trends of non-adherence with T2D medicines from 2017 to 2019, and to identify the patterns for the frequently reported reasons for non-adherence. Data from the National Health and Wellness Study (NHWS), a self-administered, annual, internet-based cross-sectional survey of US adults from 2017 to 2019 was used. Non-adherence to T2D medicines was measured using the Medication Adherence Reasons Scale (MAR-Scale). NHWS participants who self-reported taking daily prescription medication(s) to treat T2D responded to the 19 reasons for non-adherence and one global item in the scale. MAR-Scale measures non-adherence “in the past 7 days”, on an 8-point scale ranging from 0 days to 7 days. Frequencies were used to identify the reasons for non-adherence. NHWS data from 2017 had 2,983; 2018 had 5,416; and 2019 had 5,268 patients that self-reported T2D diagnosis and being prescribed daily medicine(s) (oral and/or injectable) for T2D. Based on the 19 reasons for non-adherence from the MAR-Scale, 25.11% of patients reported non-adherence to at least one reason in 2017; 20.88% in 2018; and 26.84% in 2019. The most common reason for non-adherence across all the three years was simple forgetfulness, yet patients reported the lowest mean number of days missing medication for that reason. Though less frequently reported, non-adherence lasted longer when the reason was based on beliefs in medicines. With no significant improvement in adherence with T2D medicines over time, regardless of better awareness and interventions including extensive diabetes education, focus should be on individualized non-adherence reasons-based interventions.
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