Interventions to improve adherence to medication in people with type 2 diabetes mellitus: a review of the literature on the role of pharmacists

Abstract

Summary Background and objective: Pharmacists are now adopting a crucial role in the management of chronic illness in primary care, providing diabetes care and advice. This review aims to show whether a range of diabetes care interventions delivered by pharmacists is successful in improving adherence to medication. Methods: The studies reviewed formed a subgroup of a Cochrane review on interventions to improve adherence to medication in people with type 2 diabetes. Search terms were ‘type 2 diabetes mellitus’ and ‘compliance’ or ‘adherence’. Studies were included if they assessed adherence to medical treatment specifically, rather than other aspects of self‐management. Out of the 21 studies selected for review, five described an intervention delivered by a pharmacist. Results and discussion: Two studies reported on attempts to improve adherence focused on the taking of medication. A system of reminders and packaging improved medication adherence, but measuring medicine taking through pill counts or Medication Event Monitoring System was not effective. Three studies evaluated pharmacist‐led integrated management and education programmes designed to improve glycaemic control for under‐served patient populations. They all succeeded in lowering glycated haemoglobin, but it remains unclear whether this resulted from improved patient adherence. Conclusion: This review indicates a potential benefit of pharmacist interventions to improve medication adherence in diabetes, especially in providing patient education.

Reduction of cardiovascular risk in patients with metabolic syndrome in a community health center after a pharmaceutical care program of pharmacotherapy follow-up

“…Tsuyuki et al (2002) demonstrated that pharmaceutical interventions improved the process of controlling cholesterol in high-risk patients, and Castro et al (2006) demonstrated a tendency toward better blood pressure control in resistant hypertensive patients who participated in a PC program (Castro et al, 2006). Lindenmeyer et al (2006) noted whether the intervention made by pharmacists (in approximately 21 studies) in the care of diabetics had improved adherence to medication treatment, which indicated potential benefits specifically from better educating patients (Lindenmeyer et al, 2006). These results support our findings that 82% of NOMs related to necessity were at least resolved, which implies the improvement and/or adequacy of the reference values of the majority of patients in their anthropometric parameters and lipid profiles.…”

Promoting Patient Care Through Communication Training in a Pre-clerkship Pharmacy Education Course in Japan

“…A pharmacist-patient relationship of mutual trust and understanding is established through dialogue. 13,30 The lack of experience in the pharmacy at this point could have attributed to the lack of confidence in communicating with patients, as indicated later in the slight increase from pre to post-training responses to Question 11. A comparison of the changes in student self-efficacy belief responses from the Hagemeier and colleague's study and the Japanese student responses in this study reflected similar progress in more effective interpersonal communication from pre to post training.…”

The Impact of Pharmacist-LED Medication Therapy Management on Medication Adherence in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study

“…[11][12][13][14] Medication therapy management (MTM), one of the well-established roles of pharmacists, could be used as one of the effective approaches to improve adherence to anti-diabeic medications and health outcomes. 7,15 Furthermore, clinical pharmacists, with their pharmacotherapeutic knowledge and patient centered training, are uniquely positioned to educate, elaborate, implement and monitor patients on medication therapies, which ultimately results in better health outcomes. 7,[16][17][18] Cognizant of the global paradigm shift in pharmaceutical education and practice, Public universities in Ethiopian revised their undergraduate pharmacy curriculum in 2008 to be more patient focused and a limited number of pharmacy schools also started a postgraduate course in clinical pharmacy.…”

“…7,15 Furthermore, clinical pharmacists, with their pharmacotherapeutic knowledge and patient centered training, are uniquely positioned to educate, elaborate, implement and monitor patients on medication therapies, which ultimately results in better health outcomes. 7,[16][17][18] Cognizant of the global paradigm shift in pharmaceutical education and practice, Public universities in Ethiopian revised their undergraduate pharmacy curriculum in 2008 to be more patient focused and a limited number of pharmacy schools also started a postgraduate course in clinical pharmacy. Even though there has been an increase in pharmacists' involvement in patient care in Ethiopia, their full potential and role in clinical practice is yet to be explored.…”

“…5,6 It has been known, in the past decades, that medication therapy management is associated with reduced mortality, morbidity and increased health related quality of life. 7 Yet, there has been an increase in irrational use of medicines with more than half of medicines prescribed and/or dispensed inappropriately. In addition, more than half of patients fail to adhere to their prescribed medicines.…”