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Medication is often recommended as part of ongoing therapy to reduce long-term disease risk in diabetes, but a sizable number of patients do not consistently follow their healthcare providers’ advice, investigators have found.

The researchers analyzed the use of glucose-, blood pressure- and lipid-lowering medications from the 2005 to 2006 period to 2018 to 2019 period in the Medical Expenditure Panel Survey (MEPS). Participants included more than 15,000 U.S. patients with diabetes, over 7,000 of whom were aged between 45 and 64 years. 

The MEP does not distinguish between diabetes types 1 and 2, but type 2 accounts for 90% of those with the disease in the United States and was estimated to have similar prevalence in the study, the researchers noted.

Persistent gaps in use

The researchers found “persistent and sometimes increasing gaps” in the continuity of use of these drug treatments between the two time periods. Continued use was defined as at least one fill per year.

In fact, a large number of participants living with diabetes did not use their medications at all if indicated for one or two years. This included 43% of people prescribed lipid-lowering medications, 19% of people prescribed glucose-lowering drugs and 17% prescribed blood-pressure lowering drugs. 

In the case of glucose-lowering drugs, continuity in use decreased overall between the two time periods and inconsistent or no use increased in the late 2010s. In the meantime, inconsistent use of blood pressure- and lipid-lowering medications also rose, peaking in 2017. The findings occurred on the national level, investigators reported.

Demographic factors

Demographic factors played a role in the results. Uninsured adults were more likely to use no medications or use them inconsistently for both years of follow-up. Younger or Black participants were less likely to have continuity of use between the time periods, mirroring the results of other studies, according to the researchers.

When prescribed for people with diabetes, the medications examined in the study can help to reduce the risk of macrovascular and microvascular disease that can lead to lower quality of life and poor outcomes. 

“Our nuanced characterization of longitudinal medication use by adults with diabetes suggests that multifaceted reforms to address no or inconsistent use may be needed,” the authors concluded.

Full findings were published in JAMA Network Open.

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