Medication adherence ‘excellent’ in high-volume diabetes practices
MedWire News: A well-organized diabetes program in general practice can significantly improve adherence to hypoglycemic medication, research shows.
Levels of adherence in the study were higher than previously reported using medication event monitoring systems (MEMS) among people with diabetes, report Ian Kellar (University of Cambridge, UK) and colleagues in the journal Primary Care Diabetes.
Kellar's team assessed the levels of adherence to hypoglycemic medication in a general practice diabetes care program. Sixty patients were prescribed oral hypoglycemia medication and recruited to the 2-month prospective study.
Medication adherence was measured using MEMS, a plastic container with a spring-loaded device that records the date and time the container is opened.
The majority of patients (58%) were prescribed one medication only, either metformin (32%), a sulfonylurea (22%), or a prandial glucose regulator (5%). The remaining patients were prescribed combination therapy, most frequently metformin and a sulfonylurea.
Over the 2-month study, 99.1% of the prescribed doses were taken and the drugs were taken on 96.4% of the days prescribed.
In addition, just 7% of patients took less than 90% of the prescribed doses. Roughly one in three patients took their prescribed doses on less than 90% of days.
"Indeed the majority of the 18 patients who on more than 10% of days took a different number of doses than had been prescribed appeared to take their medication more frequently than had been recommended by their doctor," report Kellar and colleagues.
There was no obvious pattern to this "over-adherence," they add.
Patients with poorer adherence tended to be younger and had higher glycated hemoglobin values than patients who took the prescribed doses more than 90% of the time.
Adherence to metformin was lower than to sulfonylureas, which may be related to dose frequency or side-effects, suggest the researchers.
Although worsening hyperglycemia has been demonstrated in treated diabetic patients, doctors should consider low adherence to drug therapy in patients with poor glycemia control before moving to prescribe more or different medication, they conclude.
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