Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Barriers to Diabetes Medication Adherence
JAMA Intern Med; ePub 2017 Jan 23; Fernández, et al
Nonadherence to newly prescribed diabetes medications is substantially greater among insured Latino patients than insured white patients, a recent study showed, and this may be due at least in part to patient-physician language barriers. This study was conducted from January 1, 2006, to December 31, 2012 and included 21,878 white patients, 5,755 English-speaking Latino patients, and 3,205 limited English proficiency (LEP) Latino patients with a total of 46,131 prescriptions for new diabetes medications. Researchers found:
- Overall nonadherence to newly prescribed diabetes medications was observed in 60.2% of Spanish-speaking Latino patients, 51.7% of English-speaking Latino patients, and 37.5% of white patients.
- English-speaking Latino patients were more likely to be nonadherent compared with white patients (RR, 1.23).
- Nonadherence among Spanish-speaking Latino patients did not vary with the Spanish-language fluency of their physicians.
Fernández A, Quan J, Moffet H, Parker MM, Schillinger D, Karter AJ. Adherence to newly prescribed diabetes medications among insured Latino and white patients with diabetes. [Published online ahead of print January 23, 2017.] JAMA Intern Med. doi:10.1001/jamainternmed.2016.8653.
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Testosterone Therapy to Prevent T2D in Men, Diabetes Care; ePub 2019 Mar 18; Yassin, et al
Patterns of Diabetes Screening During Office Visits, J Am Board Fam Med; 2019 Mar-Apr; Shealy, et al
Muscular Strength and Incidence of Type 2 Diabetes, Mayo Clin Proc; ePub 2019 Mar 11; Wang, et al
C. Everete Koop, the former Surgeon General of the United States said, “medicines don’t work in people who don’t take them.” This study shows that under the best of circumstances, over a third of patients do not take their newly prescribed medications for diabetes; among our Latino patients, that number is 50 to 60%, and does not vary according to ability to speak English. There are various reasons why these differences may exist, including differential access to pharmacies, financial barriers, literacy barriers, cultural attitudes toward medications, language barriers, and differing incidence of depression. While we can’t know the cause, we do know that emphasizing the importance of taking medications and asking if there are any hurdles that might prevent taking medications as prescribed are important parts of our visits with our patients. —Neil Skolnik, MD