Type 2s off script

Researchers from the National Centre for Drug Adherence Testing (NCAT) at Leicester’s Hospitals, together with colleagues at the University of Leicester, took urine samples from 228 patients taken at their annual diabetes review.

The urine samples were screened for 60 different medicines used to treat type 2 diabetes, heart conditions and high blood pressure (hypertension). They found that 28% of this group had either taken none, or only some, of their prescribed medicines. Failing to take prescription drugs properly is called non-adherence.

Dr Prashanth Patel, a consultant and co-director of NCAT at Leicester’s Hospitals, and study co-author, said: “These findings had a knock-on effect, as those who had not been taking their prescription drugs regularly had significantly higher blood sugar levels compared with those who had been.

We also found they were more prone to higher levels of microalbumin, a marker that the kidneys may not be healthy, as well as higher blood pressure and more fat levels in the blood, otherwise known as the lipid profile.

Study author Dr Pankaj Gupta, a consultant metabolic physician at Leicester’s Hospitals, said: “The National Centre for Drug Adherence Testing is the first and largest adherence testing centre in the world. We used a technique that objectively and robustly detect non-adherence for a range of medicines. The benefit of using this technique was that it reduced the need for doctors to rely on patients’ own self-reporting.”

Professor Kamlesh Khunti, who is Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester and is also a Co-Director at the Leicester Diabetes Centre, said: “It is difficult to diagnose non-adherence reliably through conversation alone. Many patients may not want to admit that they forget to take their medication, or for whatever reason choose not to, but it is important doctors have the full picture. Our study shows that a routine urine sample can be used to detect the person’s approach to their medication.”

This test could help initiate a discussion about the reasons for non-adherence and ways to overcome them.

The study was also published in Diabetes Care.

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