Lee Crystal M Y, Gibson Alice A, Nassar Natasha, Colagiuri Stephen
School of Population Health, Curtin University, Perth, Western Australia, Australia.
Boden Initiative, Charles Perkins Centre and Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Diabetes Obes Metab. 2025 Jul;27(7):3809-3820. doi: 10.1111/dom.16408. Epub 2025 Apr 23.
To determine the adherence rate in users of each class of glucose-lowering medication and identify the key socio-demographic factors influencing adherence.
The 45 and Up Study is an ongoing cohort study of residents aged ≥45 years in New South Wales, Australia. We analysed Pharmaceutical Benefits Scheme records from 2013 to 2019 of the 21 341 study participants who self-reported having diabetes. Medication adherence was estimated as the proportion of days covered for each 12-month period for up to the fifth 12-month period.
A consistent pattern was observed across all drug classes, where the percentage of adherent (proportion of days covered ≥0.8) users was highest in the first 12 months, followed by a drop in the second 12 months. For prevalent users on the same drug class for the full 5-year period, higher percentages of adherent users compared to the first 12 months were observed for glucagon-like peptide 1 receptor agonists (77.7% vs 74.2%). For incident users on the same drug class for the full 5-year period, a higher percentage of adherent users compared to the first 12 months was observed for sodium-glucose cotransporter 2 inhibitors (84.2% vs 78.4%). Moreover, no socio-demographic subgroup was consistently more or less adherent to medications.
Initial adherence was good and remained relatively high over time in this cohort. Nevertheless, adherence was still a challenge in some individuals. Practitioners should recognize the possibility of non-adherence and consider this at each consultation.
确定各类降糖药物使用者的依从率，并识别影响依从性的关键社会人口统计学因素。
“45岁及以上研究”是一项针对澳大利亚新南威尔士州45岁及以上居民的正在进行的队列研究。我们分析了2013年至2019年21341名自我报告患有糖尿病的研究参与者的药品福利计划记录。药物依从性以每个12个月期间直至第五个12个月期间的覆盖天数比例来估计。
在所有药物类别中均观察到一致的模式，即依从性使用者（覆盖天数比例≥0.8）的百分比在第一个12个月最高，随后在第二个12个月下降。对于在整个5年期间使用同一药物类别的现患使用者，与第一个12个月相比，胰高血糖素样肽1受体激动剂的依从性使用者百分比更高（77.7%对74.2%）。对于在整个5年期间使用同一药物类别的新发病使用者，与第一个12个月相比，钠-葡萄糖协同转运蛋白2抑制剂的依从性使用者百分比更高（84.2%对78.4%）。此外，没有一个社会人口统计学亚组在药物依从性方面始终更高或更低。
在这个队列中，初始依从性良好且随时间保持相对较高。然而，依从性对一些人来说仍然是一个挑战。从业者应认识到不依从的可能性，并在每次会诊时予以考虑。
