In one study that tracked new prescriptions written electronically over a 12-month period for >75,000 patients, 31.4% of new prescriptions for diabetes drugs were never filled. This problem, often referred to as primary nonadherence, may be particularly relevant among patients who are refusing to initiate insulin or other injectable hypoglycemic therapy, typically due to injection phobia, inconvenience, poor patient–physician communication, and/or negative patient perceptions.26