Zarrinkamar Maryam, Geran Mojgan, Geran Mohammad
Department of Family Medicine, Diabetes Research Center Mazandaran University of Medical Sciences Sari Iran.
Health Department Mazandaran University of Medical Sciences Sari Iran.
Health Sci Rep. 2025 Apr 29;8(5):e70780. doi: 10.1002/hsr2.70780. eCollection 2025 May.
Diabetes imposes a global healthcare burden, with Type 2 Diabetes Mellitus (T2DM) escalating due to demographic shifts and lifestyle changes. Combination therapies offer promise in managing T2DM, yet patient adherence remains a challenge. This scoping review aims to explore patient adherence to combination therapies in T2DM management.
This scoping review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Electronic databases including PubMed, Scopus, and Web of Science were searched until July 10, 2024. Studies focused on patients with T2DM prescribed oral combination therapies were included. Data extraction and synthesis were conducted to identify adherence patterns, influencers, and strategies.
The review identified nine eligible studies spanning from 2004 to 2021, primarily retrospective cohort and cross-sectional designs. Adherence assessment methods varied, with medication possession ratio being the most common. Both dual (loose-dose) and fixed-dose combination therapies were explored. Adherence rates varied across studies and therapies, influenced by factors such as glycemic control, weight management, economic considerations, complexity of regimens, and demographic factors. Bibliometric analysis revealed diverse geographic origins of the included studies and varied adherence assessment methods. Dual therapy regimens demonstrated adherence rates ranging from 49% to 80.8%, while FDC therapies showed adherence rates ranging from 60.3% to 98.9%. Factors influencing adherence included glycemic control, weight management, economic considerations, complexity of regimens, and demographic factors.
Patient adherence to oral combination therapies in diabetes management is complex, affected by clinical, economic, and psychosocial factors. Addressing these issues is crucial for enhancing treatment outcomes and alleviating the burden of diabetes. A patient-centered approach and innovative strategies can empower patients to adhere to medication regimens, improving health outcomes and quality of life.
糖尿病给全球医疗保健带来负担，由于人口结构变化和生活方式改变，2型糖尿病（T2DM）的发病率不断上升。联合治疗在T2DM管理中显示出前景，但患者的依从性仍然是一个挑战。本范围综述旨在探讨T2DM管理中患者对联合治疗的依从性。
本范围综述遵循系统评价和Meta分析扩展的首选报告项目（PRISMA-ScR）指南。检索了包括PubMed、Scopus和Web of Science在内的电子数据库，检索截至2024年7月10日。纳入关注接受口服联合治疗的T2DM患者的研究。进行数据提取和综合分析，以确定依从模式、影响因素和策略。
该综述确定了9项符合条件的研究，时间跨度为2004年至2021年，主要为回顾性队列研究和横断面设计。依从性评估方法各不相同，药物持有率是最常用的方法。研究了双重（松散剂量）和固定剂量联合疗法。不同研究和疗法的依从率各不相同，受血糖控制、体重管理、经济因素、治疗方案复杂性和人口统计学因素等影响。文献计量分析显示，纳入研究的地理来源多样，依从性评估方法也各不相同。双重治疗方案的依从率在49%至80.8%之间，而固定剂量复方制剂疗法的依从率在60.3%至98.9%之间。影响依从性的因素包括血糖控制、体重管理、经济因素、治疗方案复杂性和人口统计学因素。
糖尿病管理中患者对口服联合治疗的依从性很复杂，受临床、经济和社会心理因素影响。解决这些问题对于提高治疗效果和减轻糖尿病负担至关重要。以患者为中心的方法和创新策略可以使患者坚持药物治疗方案，改善健康结果和生活质量。
