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Impact of symptomatic hypoglycemia on medication adherence, patient satisfaction with treatment, and glycemic control in patients with type 2 diabetes
Karolinska Institute, Sweden Merck Sharp and Dohme Sweden AB, Sweden .
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
Motala Hospital, Sweden .
Merck Sharp and Dohme Sweden AB, Sweden Karolinska Institute, Sweden .
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2014 (English)In: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 8, 593-601 p.Article in journal (Refereed) Published
Abstract [en]

Background: The purpose of this study was to evaluate the impact of symptomatic hypoglycemia on medication adherence, satisfaction with treatment, and glycemic control in patients with type 2 diabetes based on the treatment goals stated in the Swedish national guidelines. Methods: This cross-sectional, multicenter study was carried out between January and August 2009 in 430 consecutive primary health care patients on stable doses of metformin and sulfonylureas for at least 6 months. The patients completed questionnaires covering their experiences of low blood glucose and adherence, as well as barriers to and satisfaction with drug treatment (using the Treatment Satisfaction Questionnaire for Medication). Physicians collected the data from medical records. Results: Patients who experienced moderate or worse symptoms of hypoglycemia reported poorer adherence to medication (46% versus 67%; P less than 0.01) and were more likely to perceive barriers such as "bothered by medication side effects" (36% versus 14%; P less than 0.001) compared with patients with no or mild symptoms. Patients with moderate or worse symptoms of hypoglycemia were less satisfied with their treatment than those with no or mild symptoms as determined by the Treatment Satisfaction Questionnaire for Medication-Global satisfaction (67.0 versus 71.2; P less than 0.05). Overall, achievement of target glycated hemoglobin (HbA(1c)) based on the treatment goals stated in the Swedish national guidelines was 40%. Despite poorer adherence, patients who experienced moderate or worse symptoms of hypoglycemia had lower mean HbA(1c) values than patients with no or mild symptoms (7.0% versus 7.3% [Diabetes Control and Complications Trial standard]; P less than 0.05). Conclusion: Symptomatic hypoglycemia in patients with type 2 diabetes on metformin and sulfonylureas was associated with nonadherence and decreased treatment satisfaction despite lower mean HbA(1c) values. A broader understanding of patient preferences and self-reported outcomes could improve the management of patients with type 2 diabetes.

Place, publisher, year, edition, pages
Dove Medical Press , 2014. Vol. 8, 593-601 p.
Keyword [en]
hypoglycemia; patient-reported outcomes; primary care; nonadherence; persistence; sulfonylurea
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-106990DOI: 10.2147/PPA.S58781ISI: 000335331900001Scopus ID: 2-s2.0-84899799843OAI: oai:DiVA.org:liu-106990DiVA: diva2:721056
Available from: 2014-06-03 Created: 2014-06-02 Last updated: 2017-12-05

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Pettersson, Billie

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