Patient compliance can be a difficult obstacle to overcome

Types of noncompliance and key reasons cited[1,2]

Adapted from LaRosa.

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• Among newly treated patients with type 2 diabetes, only 53.8% adhered to their treatment regimen.[3]
• Compliance problems result in higher A1C levels, more symptoms, and poorer mental and physical functioning.[4]

Fixed-dose combination tablets may help to increase patient compliance and improve efficacy[5,6]

Comparison of adjusted adherence rates before and after the switch from metformin and glyburide combination therapy to fixed-dose glyburide/metformin combination therapy. *P<0.001.

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• A1C levels significantly decreased by 0.16% for each 10% increase in drug adherence.[6]
• Another study reported a 1.4% mean difference in A1C levels between groups with optimal compliance vs the group with the worst compliance.[7]

Patient compliance is influenced by the frequency of doses taken[8]

• Patient compliance is dependent on two behavioral aspects:
• Dose taking – the number of doses taken by the patient
• Dose timing – the time between each dose that is taken
• In terms of dose taking, the average adherence rate for:
• QD dosing is 98.7%
• BID dosing is 83.1%
• TID dosing is 65.8%
• In terms of dose timing, which reflects the percentage of days in which the prescribed dose regimen was taken as prescribed, the average adherence rate for:
• QD dosing is 79.1%
• BID dosing is 65.6%
• TID dosing is 38.1% 
• QD dosing regimens are associated with higher rates of adherence than BID or TID regimens.

Patient surveys and medication logs are also useful tools to address patient compliance

• A survey can help patients understand why they have a hard time taking medications as directed. Once they identify the challenging factor, you can work with them to devise a strategy to overcome that barrier.
• “I’m too busy” – suggest taking medication when the patient brushes his/her teeth.
• “I have too many medications to take” – suggest switching to an FDC.
• “I just plain forget” – suggest using a glucose log to help them track their blood glucose and prompt medication reminders.
• Glucose logs are also helpful tools to increase patient compliance. They remind patients to check their blood glucose, which helps patients see that the medications are necessary and helpful.

The Take Action Learning Center is also a useful resource to provide for your patients. It contains various tools and tips to help your patients adhere to their treatment regimen and construct an optimal lifestyle for them to manage their type 2 diabetes.

Compliance is a difficult obstacle in effectively treating type 2 diabetes. Hopefully, these tips will have a positive impact on patient compliance, and, ultimately, blood
glucose levels!