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A large proportion of a Saudi population with type 2 diabetes mellitus was found to be non-adherent to antidiabetics: a retrospective cohort study
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  • Turki Althunian,
  • Ohoud A. Almadani,
  • Ghada M. Alsagri,
  • Hisham A. Badreldin,
  • Thamir M.Alshammari
Turki Althunian
Saudi Food and Drug Authority
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Ohoud A. Almadani
Saudi Food and Drug Authority
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Ghada M. Alsagri
Saudi Food and Drug Authority
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Hisham A. Badreldin
King Abdulaziz Medical City
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Thamir M.Alshammari
Almaarefa University College of Pharmacy

Corresponding Author:tmshammari.c@sfda.gov.sa

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Abstract

Purpose: Optimal adherence to antidiabetics among patients with type 2 diabetes mellitus has been associated with positive health outcomes; however, studies to assess this adherence in Saudi Arabia are scarce. We aimed to evaluate adherence to antidiabetics using a Saudi population. Methods: This was a multicenter, retrospective cohort study of patients (≥ 18 years old) with type 2 diabetes mellitus who received ≥ 1 antidiabetic between 2015 and 2020. Adherence was estimated using the continuous multiple-interval measure of medication availability (CMA7). A CMA7 cutoff point of ≥ 80% was chosen to define optimal adherence, and the odds of not achieving therapeutic annual HbA1c levels (i.e. ≥ 7%) in the optimal vs. suboptimal adherence groups was assessed using a logistic regression model adjusting for the measured confounders. Results: A total of 36,789 patients were included in the study. The most commonly prescribed regimens were metformin single treatment (n=15,025 [41.6%]) and gliclazide-metformin combination treatment (n=5,667 [15.7%]). The median CMA7 was 70.4%, and only 13,552 (36.9%) patients were adherent to their antidiabetics (CMA7 ≥ 80%). The odds of not achieving therapeutic HbA1c levels one year after the index date were comparable in the optimal vs. suboptimal adherence groups (odds ratio = 0.99, 95% confidence interval 0.92 to 1.05). Conclusions: This study showed that a large proportion of a Saudi population with type 2 diabetes mellitus were non-adherent to their antidiabetic treatments. Future Saudi and regional studies are needed to assess the impact of adherence on HbA1c levels and on cardiovascular outcomes.