Persistent gaps exist in continuity of medication use for adults with diabetes

A considerable proportion of adults with diabetes do not maintain continuity of use of glucose, blood pressure, or lipid medications, according to a study published online Jan. 30 in JAMA Network Open.

Puneet Kaur Chehal, Ph.D., from the Rollins School of Public Health at Emory University in Atlanta, and colleagues examined trends in longitudinal use of glucose, blood pressure, and lipid medications among adults with diabetes in the Medical Expenditure Panel Survey, using data for the 2005 to 2006 and 2018 to 2019 panels. The analytical sample included 15,237 participants with diabetes.

The researchers found that during both years of follow-up, a mean of 19.5, 17.1, and 43.3 percent of participants did not maintain continuity in use of glucose, blood pressure, or lipid medications, respectively. There was a downward trend observed in the proportion of participants who continued use of glucose-lowering medication in both years, from 84.5 to 77.4 percent in 2005 to 2006 and 2018 to 2019, respectively; this decrease coincided with increases in inconsistent use (3.3 to 7.1 percent, respectively) and no use (8.1 to 12.9 percent, respectively). An upward trend was seen in inconsistent use of blood pressure-lowering medications from 3.9 to 9.0 percent in 2005-2006 to 2018-2019. Inconsistent use of lipid-lowering medication trended upward, peaking in 2017 to 2018 at 9.9 percent.

"This outcome was found despite long-lasting guidelines that generally recommend medications as an ongoing part of therapy for adults with type 2 diabetes to reduce macrovascular and microvascular disease risk," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Merck; the work was partially funded by a grant from Merck to the Rollins School of Public Health.