Improving Adherence and Reducing Medication Discrepancies in Patients with Diabetes

2003 ◽  
Vol 37 (7-8) ◽  
pp. 962-969 ◽  
Author(s):  
Richard W Grant ◽  
Nicole G Devita ◽  
Daniel E Singer ◽  
James B Meigs
Keyword(s):  
Medication Adherence ◽  
Medical Record ◽  
Controlled Trial ◽  
Community Health Center ◽  
Improve Medication Adherence ◽  
Medication Discrepancies ◽  
Patient Reported ◽  
Patients With Diabetes ◽  
Medical Regimens ◽  
Very High

OBJECTIVE: To improve medication adherence by reducing self-reported adherence barriers, and to identify medication discrepancies by comparing physician-prescribed and patient-reported medical regimens. DESIGN: Prospective, randomized, controlled trial. SETTING AND PARTICIPANTS: A single academically affiliated community health center. Eligible patients had type 2 diabetes, had undergone laboratory testing in the year preceding the study, and had visited the clinic in the 6 months preceding the study. INTERVENTION: A pharmacist administered detailed questionnaires, provided tailored education regarding medication use and help with appointment referrals, and created a summary of adherence barriers and medication discrepancies that was entered into the medical record and electronically forwarded to the primary care provider. MEASUREMENTS: Changes in self-reported adherence rates and barriers were compared 3 months after the initial interview. Intervention patients with medication discrepancies at baseline were assessed for resolution of discrepancies at 3 months. RESULTS: Rates of self-reported medication adherence were very high and did not improve further at 3 months (6.9 of 7 d, with all medicines taken as prescribed; p = 0.3). Medical regimen discrepancies were identified in 44% of intervention patients, involving 45 doses of medicines. At 3-month follow-up, 60% of discrepancies were resolved by corrections in the medical record, while only 7% reflected corrections by patients. CONCLUSIONS: In this community cohort, patients reported few adherence barriers and very high medication adherence rates. Our patient-tailored intervention did not further reduce these barriers or improve self-reported adherence. The high prevalence of medication discrepancies appeared to mostly reflect inaccuracies in the medical record rather than patient errors.

scholarly journals Effective Engagement of Adolescent Asthma Patients With Mobile Health–Supporting Medication Adherence (Preprint)

2018 ◽  
Author(s):  
Richelle C Kosse ◽  
Marcel L Bouvy ◽  
Svetlana V Belitser ◽  
Tjalling W de Vries ◽  
Piet S van der Wal ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Mobile Health ◽  
Controlled Trial ◽  
Study Data ◽  
Improve Medication Adherence ◽  
Actual Use ◽  
Asthma Patients ◽  
Log File ◽  
Cluster Randomized ◽  
Mhealth Apps

BACKGROUND Mobile health (mHealth) apps have the potential to support patients’ medication use and are therefore increasingly used. Apps with broad functionality are suggested to be more effective; however, not much is known about the actual use of different functionalities and the effective engagement. OBJECTIVE The aim of this study was to explore the use and the effective engagement of adolescents (aged 12 to 18 years) with the Adolescent Adherence Patient Tool (ADAPT). METHODS The ADAPT intervention consisted of an app for patients, which was connected to a management system for their pharmacist. The aim of the ADAPT intervention was to improve medication adherence and, therefore, the app contained multiple functionalities: questionnaires to monitor symptoms and adherence, medication reminders, short movies, pharmacist chat, and peer chat. For this study, data of the ADAPT study and a cluster randomized controlled trial were used. Adolescents with asthma had 6 months’ access to the ADAPT intervention, and all app usage was securely registered in a log file. RESULTS In total, 86 adolescents (mean age 15.0, SD 2.0 years) used the ADAPT app 17 times (range 1-113) per person. Females used the app more often than males (P=.01) and for a longer period of time (P=.03). On average, 3 different functionalities were used, and 13% of the adolescents used all functionalities of the app. The questionnaires to monitor symptoms and adherence were used by most adolescents. The total app use did not affect adherence; however, activity in the pharmacist chat positively affected medication adherence (P=.03), in particular, if patients sent messages to their pharmacist (P=.01). CONCLUSIONS mHealth apps for adolescents with asthma should contain different functionalities to serve the diverging needs and preferences of individual patients. Suggested key functionalities to promote use and effectiveness in adolescents with asthma are questionnaires to monitor symptoms and a health care provider chat.

scholarly journals The Ready to Reduce Risk (3R) Study for a Group Educational Intervention With Telephone and Text Messaging Support to Improve Medication Adherence for the Primary Prevention of Cardiovascular Disease: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Jo L Byrne ◽  
Helen M Dallosso ◽  
Stephen Rogers ◽  
Laura J Gray ◽  
Ghazala Waheed ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Randomized Controlled Trial ◽  
Medication Adherence ◽  
Primary Prevention ◽  
Text Messaging ◽  
Controlled Trial ◽  
Improve Medication Adherence ◽  
Randomized Controlled ◽  
Prevention Of Cardiovascular Disease

BACKGROUND Poor adherence to cardiovascular medications is associated with worse clinical outcomes. Evidence for effective education interventions that address medication adherence for the primary prevention of cardiovascular disease is lacking. The Ready to Reduce Risk (3R) study aims to investigate whether a complex intervention, involving group education plus telephone and text messaging follow-up support, can improve medication adherence and reduce cardiovascular risk. OBJECTIVE This protocol paper details the design and rationale for the development of the 3R intervention and the study methods used. METHODS This is an open and pragmatic randomized controlled trial with 12 months of follow-up. We recruited participants from primary care and randomly assigned them at a 1:1 frequency, stratified by sex and age, to either a control group (usual care from a general practitioner) or an intervention group involving 2 facilitated group education sessions with telephone and text messaging follow-up support, with a theoretical underpinning and using recognized behavioral change techniques. The primary outcome was medication adherence to statins. The primary measure was an objective, novel, urine-based biochemical measure of medication adherence. We also used the 8-item Morisky Medication Adherence Scale to assess medication adherence. Secondary outcomes were changes in total cholesterol, blood pressure, high-density lipoprotein, total cholesterol to high-density lipoprotein ratio, body mass index, waist to hip ratio, waist circumference, smoking behavior, physical activity, fruit and vegetable intake, patient activation level, quality of life, health status, health and medication beliefs, and overall cardiovascular disease risk score. We also considered process outcomes relating to acceptability and feasibility of the 3R intervention. RESULTS We recruited 212 participants between May 2015 and March 2017. The 12-month follow-up data collection clinics were completed in April 2018, and data analysis will commence once all study data have been collected and verified. CONCLUSIONS This study will identify a potentially clinically useful and effective educational intervention for the primary prevention of cardiovascular disease. Medication adherence to statins is being assessed using a novel urine assay as an objective measure, in conjunction with other validated measures. CLINICALTRIAL International Standard Randomized Controlled Trial Number ISRCTN16863160; http://www.isrctn.com/ISRCTN16863160 (Archived by WebCite at http://www.webcitation.org/734PqfdQw) INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11289

scholarly journals 18 A Review of Interventions to Improve Medication Adherence in Patients with Parkinson’s Disease

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Niamh McMahon ◽  
Neasa Kelly ◽  
Martin Henman
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Medication Adherence ◽  
Assessment Tool ◽  
Data Extraction ◽  
Controlled Trial ◽  
Control Group ◽  
Improve Medication Adherence ◽  
Post Intervention ◽  
Therapy Effect

Abstract Background In Parkinson’s Disease (PD) medication adherence has been neglected. Despite evidence of successful interventions in other chronic diseases, there is currently no review of medication adherence enhancing interventions in PD populations. This review sought to identify and evaluate interventions to improve medication adherence in patients with PD. Methods Six online databases (PubMed, EMBASE, Medline, PsycINFO, CinahlCOMPLETE, AMED) were searched. Key concepts “Medication adherence” and “Parkinson’s disease” were used. Reference lists of retrieved studies were hand searched. Studies were assessed for inclusion against pre-specified eligibility criteria. Data extraction was carried out using a standardised data extraction table. Critical appraisal was undertaken using the JADAD score, CASP Randomised Controlled Trial (RCT) checklist, “Quality Assessment tool for before-after studies with no control group” and the TREND statement checklist. Results The search resulted in 612 records of which five met inclusion criteria (3 RCT, 2 before-after studies). A total of 496 PD patients were included. Interventional strategies investigated were educational intervention, adherence therapy, effect of a Parkinson’s Tracker App (PTA) and intervention by a pharmacist. Five (100%) of the studies included in this review reported a statistically significant improvement in medication adherence post-intervention and some improvements in symptoms. Conclusion This is the first review of medication adherence in the PD population. Several different interventions proved effective in enhancing medication adherence, but the studies were small, short term and the risk of bias ranged from moderate to high. Consequently, the results may not be generalisable to other PD populations.

scholarly journals Validity and reliability of anti-diabetic medication adherence scale among patients with diabetes in Baghdad, Iraq: a pilot study

2019 ◽  
Vol 7 (1) ◽  
pp. e000658 ◽  
Author(s):  
Ehab Mudher Mikhael ◽  
Saad A Hussain ◽  
Nizar Shawky ◽  
Mohamed Azmi Hassali
Keyword(s):  
Medication Adherence ◽  
Convergent Validity ◽  
Glycosylated Hemoglobin ◽  
Diabetes Patient ◽  
Arab Countries ◽  
Validity And Reliability ◽  
Significant Difference ◽  
Patient Reported ◽  
Patients With Diabetes ◽  
Adherence Scale

BackgroundMedication non-adherence is a common problem among patients with diabetes. Patient-reported medication adherence scales are the most commonly used method to assess patient medication adherence, but up to today there is no specific tool for assessing medication adherence among patients with diabetes in Arab countries. This study aimed to develop and validate a new tool for assessment of adherence to antidiabetic medications among Iraqi patients with diabetes.MethodsThe Iraqi Anti-Diabetic Medication Adherence Scale (IADMAS) consists of eight items. The face and content validity of the IADMAS were established via an expert panel. For convergent validity, the IADMAS was compared with the Medication Adherence Questionnaire (MAQ). For concurrent validity, the IADMAS was compared with glycosylated hemoglobin. A total of 84 patients with types 2 diabetes were recruited from a diabetes center in Baghdad, Iraq. Test–retest reliability was measured by readministering the IADMAS to the same patients 4 weeks later.ResultsOnly 80 patients completed the study (response rate: 95%). Reliability analysis of the IADMAS showed a Cronbach’s alpha value of 0.712, whereas that of the MAQ was 0.649. All items in the IADMAS showed no significant difference in the test–retest analysis, indicating that the IADMAS has stable reliability. There was no difference in the psychometric properties of the IADMAS and the MAQ. The sensitivity and specificity of the IADMAS were higher than that of the MAQ (100% vs 87.5% and 33.9% vs 29.7%, respectively).ConclusionThe IADMAS developed in this study is a reliable and valid instrument for assessing antidiabetic medication adherence among Iraqi patients.

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