Prashanth Patel1,2, Pankaj Gupta3,2, Angela Burns1, Ali A Mohamed1, Richard Cole1, Dan Lane1, Samuel Seidu4,5, Kamlesh Khunti4,5. 1. Department of Chemical Pathology and Metabolic Diseases, University Hospitals of Leicester NHS Trust, Leicester, U.K. 2. Department of Cardiovascular Sciences, University of Leicester, Leicester, U.K. 3. Department of Chemical Pathology and Metabolic Diseases, University Hospitals of Leicester NHS Trust, Leicester, U.K. pankaj.gupta@uhl-tr.nhs.uk. 4. Leicester Diabetes Centre, Leicester General Hospital, Leicester, U.K. 5. Diabetes Research Centre, University of Leicester and Leicester General Hospital, Leicester, U.K.
Abstract
OBJECTIVE: Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is a new method to objectively and robustly detect nonadherence. We applied this technique to study nonadherence to cardiovascular medications in people with type 2 diabetes (T2DM). RESEARCH DESIGN AND METHODS: Routine urine samples, received at the time of the annual diabetes review from 228 people with T2DM in primary care, were assessed for adherence by LC-MS/MS. RESULTS: A total of 28.1% patients (N = 64) were nonadherent to antidiabetic, antihypertensive, and/or lipid-lowering medications. Nonadherence to statins was the highest at 23.7%, and nonadherence to oral hypoglycemic agents was 9.3%. HbA1c, albumin-to-creatinine ratio, and lipid profiles were significantly higher in the patients who were nonadherent compared with those who were adherent to treatment. CONCLUSIONS: This unique study shows that routine urine samples can be used for adherence testing screening by LC-MS/MS and has demonstrated high nonadherence rates especially to statins in people with T2DM. Future intervention studies using LC-MS/MS as a diagnostic/therapeutic tool may help to improve clinical outcomes.
OBJECTIVE: Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is a new method to objectively and robustly detect nonadherence. We applied this technique to study nonadherence to cardiovascular medications in people with type 2 diabetes (T2DM). RESEARCH DESIGN AND METHODS: Routine urine samples, received at the time of the annual diabetes review from 228 people with T2DM in primary care, were assessed for adherence by LC-MS/MS. RESULTS: A total of 28.1% patients (N = 64) were nonadherent to antidiabetic, antihypertensive, and/or lipid-lowering medications. Nonadherence to statins was the highest at 23.7%, and nonadherence to oral hypoglycemic agents was 9.3%. HbA1c, albumin-to-creatinine ratio, and lipid profiles were significantly higher in the patients who were nonadherent compared with those who were adherent to treatment. CONCLUSIONS: This unique study shows that routine urine samples can be used for adherence testing screening by LC-MS/MS and has demonstrated high nonadherence rates especially to statins in people with T2DM. Future intervention studies using LC-MS/MS as a diagnostic/therapeutic tool may help to improve clinical outcomes.
Authors: Jelle M Beernink; Milou M Oosterwijk; Kamlesh Khunti; Pankaj Gupta; Prashanth Patel; Job F M van Boven; Hiddo J Lambers Heerspink; Stephan J L Bakker; Gerjan Navis; Roos M Nijboer; Gozewijn D Laverman Journal: Diabetes Care Date: 2021-04-23 Impact factor: 17.152
Authors: Jo L Byrne; Helen M Dallosso; Stephen Rogers; Laura J Gray; Ghazala Waheed; Prashanth Patel; Pankaj Gupta; Yvonne Doherty; Melanie J Davies; Kamlesh Khunti Journal: BMC Med Date: 2020-07-27 Impact factor: 8.775