medwireNews: Objective analysis of urine samples shows that some patients with type 2 diabetes do not take their antihypertensive, antihyperlipidemic, and oral hypoglycemic medications as prescribed.
“This could be used to inform clinical decisions about treatment alteration and to improve patient outcomes,” write Pankaj Gupta (University Hospitals of Leicester NHS Trust, UK) and team in Diabetes Care.
The researchers tested the urine samples using liquid chromatography–tandem mass spectrometry. They note that reliable diagnosis of medication nonadherence “remains a major unmet clinical need.”
The team found that 5.7% of 228 patients had no trace of any of their prescribed medications in their urine sample, given for microalbuminuria screening at an annual check-up in primary care. And a further 22.4% of patients had at least one prescribed medication absent from their urine sample.
Statins were most commonly not taken as prescribed, at 23.7%, whereas prescribed oral diabetes medications were absent from 9.3% of samples. The researchers note that the true rate of medication nonadherence could be higher, due to people being more diligent in the run-up to a medical appointment.
Suboptimal medication use was associated with significantly higher glycated hemoglobin and albumin-to-creatinine ratios compared with taking medications as prescribed, and with worse lipid profiles, implying that these short-term findings may reflect longer-term medication-taking behavior.
“Anecdotally, the test is well accepted by patients and helps to initiate a discussion about the reasons for nonadherence and ways to overcome them,” says the team.
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