17 ISSN 1758-1907 Diabetes Manag. (2015) 5(1), 17–24 part of Diabetes Management 10.2217/DMT.14.45 © 2015 Future Medicine Ltd RESEARCH ARTICLE Adherence to treatment guidelines in Type 2 diabetes patients failing metformin monotherapy in a real-world setting Kaan Tunceli 1 , Inbal Goldshtein 2 , Shengsheng Yu 1 , Ofer Sharon 1 , Kimberly Brodovicz 1 , Noga Gadir 1 , Harvey Katzef 1 , Bernd Voss 1 , Larry Radican 1 , Gabriel Chodick 2,3 , Varda Shalev 2,3 , Yasmin Maor 3,4 & Avraham Karasik* ,3,4 1 Merck & Co, Inc., Whitehouse Station, NJ 08889, USA 2 Maccabi Healthcare Services, Tel Aviv, Israel 3 Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel 4 Sheba Medical Center, Tel Hashomer, Israel *Author for correspondence: Tel.: +972 3530 2815; Fax: +972 3530 2083; karasik@tau.ac.il SUMMARY Aim: To describe the drug management of T2DM patients in a real life cohort with suboptimal HbA1c after treatment with metformin monotherapy. Methods: we performed a retrospective cohort analysis of computerized medical records after measuring an HbA1c >7% for the irst time following at least 90 days on metformin therapy. Results: Among 7705 eligible patients, 56% (n = 4336) changed treatment within 1-year, by increasing metformin dose (36%), adding drugs (60%), or switching to other medications (4%). Strongest predictors of change were higher HbA1c, younger age and higher socioeconomic status (SES). Conclusion: In this cohort, the extent of inertia appears to be smaller than that reported in previous studies. Nonetheless, disease management programs aimed at improving guideline adherence and reducing inertia are still warranted. Summary points Background ● The importance of proactive diabetes treatment has been reinforced by recent diabetes guidelines. Understanding the magnitude of clinical inertia in a real world cohort of patients with Type 2 diabetes mellitus, and understanding the factors afecting intensity of care may improve diabetes care. Results ● Overall, 7705 patients were identiied in a large computerized database of an Israeli HMO, in whom HbA1c >7% was measured for the irst time following at least 90 days on metformin therapy. Of these, 56% (n = 4336) changed treatment within 1-year, by increasing metformin dose (36%), adding drugs (60%), or switching to other medications (4%). ● Strongest predictors of change were higher HbA1c, younger age and higher socioeconomic status (SES). Conclusion ● In this cohort, the extent of inertia appears to be smaller than that reported in previous studies. The may be due to intensive implementation of guidelines. For reprint orders, please contact: reprints@futuremedicine.com