Development, Validation, and Application of a Diabetes Drug Discontinuation Questionnaire: A Multicentric...

Area of Science:

• Endocrinology and Metabolism
• Public Health
• Pharmaceutical Sciences

Background:

• Medication adherence is crucial for managing diabetes, but discontinuation poses significant risks like metabolic decompensation.
• Anti-diabetes medication discontinuation is poorly understood, lacking standardized definitions and assessment tools.

Purpose of the Study:

• To develop and validate a culturally adapted, self-administered questionnaire for assessing anti-diabetes medication discontinuation.
• To determine the prevalence, duration, and associated factors of medication discontinuation in a Northern Indian population.

Main Methods:

• A multicenter observational study in Northern India involving 747 adult diabetes patients.
• Development and psychometric validation of a structured, self-administered questionnaire.
• Assessment of discontinuation patterns and influencing factors.

Main Results:

• 25.3% of participants reported discontinuing anti-diabetes medication for over seven days, with many episodes lasting months to over a year.
• Discontinuation was linked to higher HbA1c (approx. 0.5% higher), fasting, and post-prandial glucose levels.
• Key reasons for discontinuation included medication unavailability, fear of hypoglycemia, perceived good glycemic control, and belief that medication was unnecessary.

Conclusions:

• Medication discontinuation is a prevalent issue in diabetes care, affecting about one in four patients, often for prolonged durations.
• A validated questionnaire is now available to reliably assess anti-diabetes medication discontinuation in India.
• Interventions should address patient education and utilize digital adherence support systems to combat discontinuation, focusing on knowledge and access barriers.