How to Improve Adherence in Diabetes
Medication adherence among patients with diabetes is often poor.
Patient adherence to chronic medication tends to decline over time. Some experts estimate that at 1 year, only 60% of patients are still regularly taking medications as prescribed. Medication adherence among patients with diabetes, even those who are enrolled in and closely supervised by clinical trials, is often poor.
Researchers from Cedarville University School of Pharmacy in Cedarville, Ohio examined pharmacists' impact on adherence during clinical trials. The study, published in Clinical Therapeutics, indicates that pharmacists who actively intervene with patients improve outcomes.
The study looked at 12 clinical trials of non-insulin glucose-lowering medications. In each study, pharmacists employed by the research-coordinating company contacted patients at predetermined times. The pharmacists documented interventions carefully.
The pharmacists made almost 26,000 telephone calls to patients, and delivered important interventions in almost half of the calls. Overall, 92.3% of patients were recipients of interventions over the course of the studies.
Adverse events ranked number 1 among intervention types, followed by protocol violations, and miscellaneous concerns. Approximately 55% of interventions were rated "high-impact," meaning they would affect trial outcomes and patient adherence.
The researchers wrote that they conducted this study in the clinical trials venue because each day that a trial continues unnecessarily creates costs of $37,000 related to trial operations and $1.1 million in lost revenue.
While clinical trials data are not always easily translated to real-world situations, in this case, one message is clear: pharmacists can identify and resolve medication-related problems for patients with diabetes effectively. Simply inviting patients to discuss their medications and ask questions may improve outcomes.
Martinez J, Laswell E, Cailor S, Ballentine J. Frequency and impact of pharmacist interventions in clinical trial patients with diabetes. Clin Ther. 2017 Mar 9. pii: S0149-2918(17)30126-1. doi: 10.1016/j.clinthera.2017.02.006. [Epub ahead of print].