Does intervention by an allied health professional discussing adherence to medicines improve this adherence in Type 2 diabetes?

Abstract

In conclusion, prior to undertaking an intervention to improve adherence to medicines in Type 2 diabetes, it is necessary to know the baseline level of adherence, and if adherence is already high there is no point in undertaking an intervention. When adherence to medicines is low, it is not clear which interventions will improve adherence, and further studies are needed to clarify this.

Effects of interventions promoting monitoring of medication use and brief messaging on medication adherence for people with Type 2 diabetes: a systematic review of randomized trials

“…Across all patient groups, evidence for effective interventions that can support patients in taking their medication is inconsistent and only a minority of trials with a low risk of bias show improvement in adherence and clinical outcomes [4]. Similar findings have been found in systematic reviews focusing on adherence in patients with diabetes [5][6][7][8][9]. Increasingly, interventions are complex, addressing multiple factors, using behavioural, affective and provider-focused components [10].…”

Adherence to Therapies in Patients with Type 2 Diabetes

“…In the treatment of major depressive disorder, patient compliance was better with once-weekly (85.9%) compared with daily (79.4%) fluoxetine treatment [81], and similar observations were made with bisphosphonate treatment for osteoporosis [82]. Nevertheless, when adherence was poor not all studies demonstrated improvements with less frequent dosing [52]. Although the frequency of dosing appeared to have a significant impact on adherence in most cases, efficacy and safety also remained an important determinant of patient preference [83].…”

“…There have been many trials of educational intervention methods involving allied health professionals, which have resulted in increased adherence where benefits outweigh the costs associated with the intervention [52, 53]. However, the effects of such interventions are inconsistent between studies and more research of methods to reduce nonadherence and validate cost effectiveness for diabetes is required [54].…”

“…When adherence education was added to pharmacotherapy for 172 patients with uncontrolled diabetes, mean fasting blood glucose and HbA 1c values of patients in the intervention group decreased significantly compared with those in the control group ( P  < 0.001) after 3 months [86]. However, data from a comprehensive literature review suggested that such interventions did not improve adherence if it was already high [52]. …”

Effectiveness and Content Analysis of Interventions to Enhance Oral Antidiabetic Drug Adherence in Adults with Type 2 Diabetes: Systematic Review and Meta-Analysis

“…Second, psychosocial theory was used in only one of the interventions included in our meta-analysis [37], but a literature review suggests that more effective use of behavior change theory may increase intervention effects [51]. Third, the level of OAD adherence at baseline was already high in 4 of the 10 studies [37 -39,45], which decreased the opportunity to improve adherence with an intervention [52]. Finally, the small effect observed could be explained by poor intervention delivery [53].…”