{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:02:37Z","timestamp":1793754157382,"version":"4.6.1"},"reference-count":136,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diabetologia"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Medication adherence is critical for optimal glycaemic management and the prevention of complications in type 2 diabetes mellitus. Despite its importance, non-adherence remains a prevalent issue, with global estimates suggesting that approximately 38% of people with type 2 diabetes do not take their medications as prescribed, although estimates vary widely due to a range of patient-related, socioeconomic, condition-related (e.g. chronicity, severity of comorbidities) and healthcare system factors. This review synthesises the current evidence on the prevalence of non-adherence in type 2 diabetes, as well as risk factors and clinical and economic consequences, and evaluates interventions designed to improve adherence in this population. Medication non-adherence is associated with increased HbA\n                    <jats:sub>1c<\/jats:sub>\n                    levels and risks of micro- and macrovascular complications, hospitalisation and mortality, while also incurring substantial healthcare costs. Methods for assessing medication adherence range from subjective self-report tools to objective measures such as biochemical testing, which are gaining prominence in both research and clinical practice. Numerous interventions to increase medication adherence have been investigated, including educational, technological, pharmacist-led, behavioural and financial strategies and fixed-dose combination (FDC) therapies. While interventions such as pharmacist-led care and FDC therapies are beneficial, outcomes from technology-based and motivational strategies remain mixed. Shared decision making and behavioural interventions, such as cognitive behavioural therapy, may provide additional benefits, particularly for individuals with multiple long-term conditions or psychological comorbidities. Multifaceted interventions tailored to individual barriers and sustained over time appear most effective. Given the significant impact of non-adherence on both patient outcomes and healthcare systems, future research is needed to design personalised, multicomponent interventions that are scalable and equitable across diverse healthcare settings.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical Abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s00125-025-06617-x","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T23:12:18Z","timestamp":1764371538000},"page":"541-556","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Improving medication adherence in type 2 diabetes: strategies for better clinical and economic outcomes"],"prefix":"10.1007","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0410-5788","authenticated-orcid":false,"given":"Patrick J.","family":"Highton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark P.","family":"Funnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Zaccardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee-Ling","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Seidu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-7099","authenticated-orcid":false,"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"6617_CR1","volume-title":"Adherence to long-term therapies: evidence for action","author":"E Sabat\u00e9","year":"2003","unstructured":"Sabat\u00e9 E (2003) Adherence to long-term therapies: evidence for action. 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Data sharing is not applicable to this article.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"This article received no specific funding from any funding agency in the public, commercial or not-for-profit sectors. PJH is supported by an NIHR Advanced Research Fellowship (NIHR303176). PG, SS, MPF and KK are supported by the NIHR Applied Research Collaboration East Midlands (ARC EM). PG and KK are supported by the NIHR Leicester Biomedical Research Centre (BRC). KK is supported by the NIHR Global Health Research Centre for Multiple Long-Term Conditions and the Cross-NIHR Collaboration for Multiple Long-Term Conditions. L-LL is supported by Universiti Malaya (IF024-2025). The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or UK Department of Health and Social Care.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"FZ has acted as a consultant for Servier, Menarini and Daiichi Sankyo. L-LL has received research grants via her institution from Abbott Diabetes Care, AstraZeneca and Novartis; and speaker honoraria from Abbott, AstraZeneca, Boehringer Ingelheim, Novo Nordisk, Roche Diabetes Care and Zuellig Pharma. SS has received grants from Sanofi, AstraZeneca, Novo Nordisk, Boehringer Ingelheim, Servier and Lilly; speaker fees from Boehringer Ingelheim, Lilly, MSD, Novartis, Novo Nordisk, Janssen, Amgen, Sanofi, AstraZeneca, Abbott, Menarini, Dexcom and Daiichi Sankyo; travel support from AstraZeneca, Abbott, Menarini and Dexcom; and advisory board fees from Boehringer Ingelheim, Lilly, Novo Nordisk, AstraZeneca, Abbott and Dexcom. KK has acted as a consultant or speaker for, or received grants for investigator-initiated studies from, AstraZeneca, Bayer, Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp & Dohme, Boehringer Ingelheim, Oramed Pharmaceuticals, Pfizer, Roche, Daiichi Sankyo and Applied Therapeutics. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"The idea for the article was conceived by KK. PJH drafted the article with support from all authors, and all authors were responsible for reviewing it critically for important intellectual content. All authors approved the version to be published.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}