African American and Latino adults with diabetes experience a 50-100% higher burden of illness and mortality from diabetes,have worse glycemic control and experience more barriers to diabetes self-management than non-Latino white adults. Successful medication management, a critical component of diabetes treatment, requires a partnership between providers who initiate and titrate effective medications and patients who adhere to the
agreed-upon regimen.
However, multiple factors can adversely influence medication decision-making, leading to failure to intensify medications and high rates of poor medication adherence, often leading to disease progression, premature disability, and death. Barriers to adherence, including side effects, lack of understanding of and trust in treatments, and regimen complexity are often not identified or addressed. Poorer medication adherence partially explains higher rates of poor glycemic and blood pressure control in Latino and African American adults with diabetes.
Further, when adherent patients have poor control, clinicians often do not intensify medication regimens, with even lower rates of intensification among ethnic/racial minority patients Providing adequate information to patients about potential benefits and costs of medications and discussing treatment preferences are essential for improved adherence and timely medication initiation or intensification. However, these conversations can be time consuming for clinic visits.