Association of Unmet Social Needs with Metformin Use Among Patients with Type 2 Diabetes
Objective: To evaluate the relationship between social needs and metformin use among adults with type 2 diabetes (T2D).
Research Design and Methods: In a prospective cohort study of adults with T2D (n=722) we linked electronic health record (EHR) and Surescripts (Surescripts, LLC) prescription network data to abstract data on patient reported social needs and to calculate metformin adherence based on expected refill frequency using a proportion of days covered methodology.
Results: Adjusting for demographics and clinical complexity, 2 or more social needs (-0.046, 95%CI=-0.089,-0.003), being uninsured (-0.052, 95%CI=-0.095,-0.009) and while adjusting for other needs, being without housing (-0.069 95% CI=-0.121, -0.018), and lack of access to medicine/health care (-0.058 95% CI=-0.115, -0.000) were associated with lower use.
Conclusions: We found that overall social need burden and specific needs, particularly housing and healthcare access were associated with clinically significant reductions in metformin adherence among T2D patients.