OBJECTIVE: To identify and review studies that attempted to understand directly from the perspective of people with type 2 diabetes (T2D), treatment-related attributes that are associated with their medication-taking behaviors.

METHODS: Bibliographic databases (EMBASE, PUBMED) were searched for studies (Jan 2005–May 2021) wherein a person with T2D (PwD) directly expressed the treatment-related attributes associated with their decision to initiate, adhere to, or discontinue a T2D medication. Studies reporting attributes associated with oral antidiabetes drugs or injectables (not insulin) were eligible. Studies that did not explicitly explore the link between attributes and behaviors (e.g. most discrete choice experiments [DCE]), were excluded, as were those interrogating electronic medical records or claims databases.

RESULTS: 6464 studies were identified of which 16 met inclusion criteria and were included. Studies were conducted across several countries (USA most frequently, n=8 including three multi-country studies). The impact of treatment attributes was described on initiation (n=3), adherence (n=11), and discontinuation (n=4), with some studies evaluating multiple behaviors. Studies employed structured questionnaires (n=10), qualitative approaches (n=4), or DCE explicitly exploring the link to medication-taking behavior (n=2). Attributes were solicited via both closed- (n=10) and open-ended questioning (n=6). Across studies, a range of factors including glycemic efficacy (n=9), weight change (n=9), dosing frequency (n=9), hypoglycemia (n=8), gastrointestinal adverse events (n=8), complexity (n=6), route (n=3), and injection-site reactions (n=2) were reported as having an influence on medication-taking behaviors. Of the studies that used structured questionnaires, nine reported the proportion of PwD indicating that individual attributes influenced behavior; two included Likert scales to help determine the impact level of different attributes.

CONCLUSIONS: This review identified several PwD-reported treatment-related attributes that influence medication-taking behavior. Such insights gained directly from PwD could help to inform treatment decisions, facilitate shared decision-making and PwD engagement, and may potentially improve medication adherence and clinical outcomes.