Improving medication adherence in type 2 diabetes: strategies for better clinical and economic outcomes – Published online 28/11/2025

Patrick J. Highton, Mark P. Funnell, Pankaj Gupta, Francesco Zaccardi, Lee-Ling Lim, Samuel Seidu, Kamlesh Khunti

Medication non-adherence is highly prevalent among individuals with type 2 diabetes, contributing to adverse clinical outcomes including worse glycaemic management, micro- and macrovascular complications, higher hospitalisation and mortality rates and greater healthcare costs. Medication non-adherence, which can be measured by varied subjective and objective methodologies, is driven by numerous factors relating to the individual, healthcare system and personal beliefs. In this issue, Highton et al (https://doi.org/10.1007/s00125-025-06617-x) summarise the evidence on strategies to improve medication adherence in type 2 diabetes, including educational interventions, technological support, pharmacy involvement, behavioural and cognitive support interventions, financial incentives and dose-simplification strategies. The authors highlight that, although each method has demonstrated benefits, the results are mixed and it is likely that beneficial interventions will be multifaceted (i.e. comprising different strategies) and tailored to the needs of the individual, including their specific barriers to medication adherence. The authors conclude that interventions should be sustained in the longer term to maximise effectiveness and should be scalable and equitable across diverse healthcare settings. The figures from this review are available as a downloadable slideset.

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