Therapeutic adherence: A prospective drug utilization study of oral hypoglycemic in patients with type 2 diabetes mellitus

ObjectiveTo determine the drug utilization patterns and outcomes of treatment in terms of metabolic control in the type 2 diabetic patients on oral hypoglycemic agents in the outpatient department in the teaching hospital of Hamdard University, New Delhi, India.MethodsPatients with established type 2 diabetes (n=184) visiting the outpatient department were interviewed using a structured questionnaire over a period of five months.ResultsMajority of the type 2 diabetic patients in this setting were treated with a multiple oral hypoglycemic agents. The most commonly prescribed oral hypoglycemic agent was biguanides (metformin) followed by sulfonylureas (glimepiride), thiazolidinediones (pioglitazone), alpha-glucosidase inhibitors (miglitol) and dipeptidyl peptidase-4 inhibitors (vildagliptin). As monotherapy metformin was the most common choice followed by glimepiride and voglibose, the most prevalent multiple therapy was a three-drug combination of glimepiride + metformin + pioglitazone. The study showed poor compliance to the prescribed therapy.ConclusionsThis study prospected the need of patient education and counselled to enhance the patient compliance for prescribed oral hypoglycemic agents and concomitant drugs. There is need for diet control as well as blood glucose and HbA1c monitoring. Metabolic control was found to be poor in the study population. HbA1c monitoring was underutilized. Clinical monitoring of patient's adherence to the prescribed treatment to achieve good glycemic control is recommended. Measures should be taken to improve patient's adherence to the prescribed treatment.