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A comparative analysis of a novel biochemical urine screen with pharmacy prescription records and a self- reported questionnaire to assess non-adherence in people with type 2 diabetes mellitus

Department of Health Sciences

Leicester United Kingdom Cardiology Endocrinology Pharmacology

About the Project

Supervisors: Dr Pankaj Gupta, Professor Kamlesh Khunti & Dr Samuel Seidu

Start Date: As soon as possible

Non-adherence is defined as: “the extent to which a person’s behaviour – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider”. Non-adherence in chronic cardiometabolic diseases including diabetes is very common and is often the primary reason for treatment failure. This leads significant excess costs to the health economy through avoidable investigations, treatment escalations, hospital admissions, and disease complications.

Methods to diagnose non-adherence have until recently been poor. We have recently developed an objective and robust biochemical method to detect the presence of 160 cardiovascular medications in urine using high performance liquid chromatography–tandem mass spectrometry (LC-MS/MS). Biochemical adherence testing has not been utilised in people with diabetes, further its relationship with other measures of adherence is unknown.

The main aim of this observational study is to compare biochemical non-adherence with other commonly used measures of non-adherence in people with diabetes. Biochemical testing for non-adherence will be performed using urine provided by 600 patients with poorly controlled diabetes attending primary care recruited over a 15-month period. Participants will also be required to complete a self- reported questionnaire and pharmacy records will be reviewed to ascertain prescription refill rates. The prevalence and metabolic control of non-adherence as diagnosed biochemically will be compared with those obtained by pharmacy refill rates and patient self-reported questionnaires. Further, the determinants of non-adherence as ascertained by urine LC-MS/MS analysis will be studied.

It is hoped that this innovative study will lead to further larger intervention studies that will change the management of non-adherence in diabetes.

The Diabetes Research Centre (University of Leicester) is a world leader in diabetes research, and the Department of Chemical Pathology and Metabolic Medicine is a world leader in biochemical testing of non-adherence.

We are looking for high calibre students who have a UK Bachelor Degree with at least 2:1 in a relevant subject or overseas equivalent, plus an MSc (desirable).

Eligibility: Home/EU *International. *International students are eligible to apply, but will need to evidence how the shortfall in fees and living expenses will be covered.  

If there are any queries please contact : Dr P Gupta, Consultant Metabolic Medicine, University Hospitals of Leicester NHS Trust and Associate Professor, Department of Cardiovascular Sciences, University of Leciester; e-mail:  Tel:01162586550

Please refer to the following link on how to apply:

Funding Notes

This 3-year studentship provides:
- UK/EU tuition fee waiver
- Annual stipend at UKRI rates (£15,285 for 2020/21)
- Research Training Support Grant of £1,000 p/a for 3 years
Home/EU *International. *International students are eligible to apply, but will need to evidence how the shortfall in fees and living expenses will be covered.

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