Table 2.

Factors affecting adherence and persistence to metformin [19]

Patient-related barriers	Practitioner-related barriers	Treatment-related barriers
Difficulties in understanding the rationale for long-term metformin treatment	Poor health care team-patient relationship	Regimen complexity, especially in patients with multiple comorbid conditions
Difficulty swallowing; psychological difficulty swallowing tablets	Lack of times for in-depth communication with patient	Large size of or rough coating on metformin tablets
Memory problems (e.g., in older patients)	Lack of awareness of problems with treatment adherence	Inflexible treatment regimens
Socioeconomic factors (e.g., medication costs, lack of support during treatment)		Gastrointestinal side effects
Cultural attitudes and beliefs