Document Detail


Adherence in patients transferred from immediate release metformin to a sustained release formulation: a population-based study.
MedLine Citation:
PMID:  19267712     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Metformin is the most commonly prescribed oral agent used in the treatment of type 2 diabetes. It is effective at reducing glycosylated Haemoglobin (HbA1c) and decreasing microvascular and macrovascular disease. However, up to 25% of patients develop gastrointestinal side effects leading to cessation in 5-10% of users. Metformin XL (glucophage SR) is a once a day preparation that delays absorption, leading to decreased peak metformin concentrations. We hypothesised that the XL preparation of metformin would be better tolerated than the standard immediate release (IR) preparation leading to improved adherence to therapy. METHODS: In a retrospective observational study, we studied adherence and glycaemic control in patients prescribed metformin IR and XL preparations in Tayside, UK. RESULTS: Metformin XL was used by 137 patients during the study period. Overall adherence was greater in the XL group (80%) compared with the 10,772 patients in the IR group (72%, p = 0.0026). In the 40 patients who changed from metformin IR to metformin XL who had sufficient data to determine adherence, the adherence increased from 62% in the IR group to 81% in the XL group (p < 0.0001). This was associated with an HbA1c reduction from 9.1 to 8.4% (p = 0.0739, n = 29). CONCLUSIONS: Metformin XL use is associated with increased adherence compared with the IR preparation, although the mechanism for this cannot be determined from this study. In patients intolerant of metformin IR the XL preparation should be considered.
Authors:
L A Donnelly; A D Morris; E R Pearson
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetes, obesity & metabolism     Volume:  11     ISSN:  1463-1326     ISO Abbreviation:  Diabetes Obes Metab     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-09     Completed Date:  2010-01-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883645     Medline TA:  Diabetes Obes Metab     Country:  England    
Other Details:
Languages:  eng     Pagination:  338-42     Citation Subset:  IM    
Affiliation:
Health Informatics Centre, University of Dundee, Dundee, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Delayed-Action Preparations
Diabetes Mellitus, Type 2 / blood,  drug therapy*
Drug Administration Schedule
Female
Hemoglobin A, Glycosylated / metabolism
Humans
Hypoglycemic Agents / administration & dosage*
Male
Medical Record Linkage
Metformin / administration & dosage*
Middle Aged
Patient Compliance / statistics & numerical data*
Retrospective Studies
Scotland
Chemical
Reg. No./Substance:
0/Delayed-Action Preparations; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/hemoglobin A1c protein, human; 657-24-9/Metformin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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