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: After adjusting for demographics and clinical complexity, two 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 health care access, were associated with clinically significant reductions in metformin adherence among patients with T2D.