Assessment of patient knowledge of diabetic goals, self-reported medication adherence, and goal attainment

Abstract

Background:Medication adherence is an integral aspect of disease state management for patients with chronic illnesses, including diabetes mellitus. It has been hypothesized that patients with diabetes who have poor medication adherence may have less knowledge of overall therapeutic goals and may be less likely to attain these goals.Objective:The purpose of this study was to assess self-reported medication adherence, knowledge of therapeutic goals (hemoglobin A1C [A1C], low density lipoprotein cholesterol [LDL-C] and blood pressure [BP]), and goal attainment in adult patients with diabetes.Methods:A survey was created to assess medication adherence, knowledge of therapeutic goals, and goal attainment for adult patients with diabetes followed at an internal medicine or a family medicine clinic. Surveys were self-administered prior to office visits. Additional data were collected from the electronic medical record. Statistical analysis was performed.Results:A total of 149 patients were enrolled. Knowledge of therapeutic goals was reported by 14%, 34%, and 18% of survived patients for LDL-C, BP, and A1C, respectively. Forty-six percent, 37%, and 40% of patients achieved LDL-C, BP, and A1C goals, respectively. Low prescribing of cholesterol-lowering medications was an interesting secondary finding; 36% of patients not at LDL-C goal had not been prescribed a medication targeted to lower cholesterol. Forty-eight percent of patients were medication non-adherent; most frequently reported reasons for non-adherence were forgot (34%) and too expensive (14%). Patients at A1C goal were more adherent than patients not at goal (p=0.025).Conclusion:The majority did not reach goals and were unknowledgeable of goals; however, most were provided prescriptions to treat these parameters. Goal parameters should be revisited often amongst multidisciplinary team members with frequent and open communications. Additionally, it is imperative that practitioners discuss the importance of medication adherence with every patient at every visit.

Diabetic Patients’ Knowledge of Therapeutic Goals in Kuwait

“…The current results would be the first step in providing a quantitative measurement, and could be utilized in designing and targeting interventions to alleviate the identified problems and improve diabetic patients' knowledge about therapeutic goals, since unawareness of the importance of therapeutic goal attainment and lack of knowledge with regard to therapeutic goals have been recognized as limitations to patients achieving these goals [9] .…”

“…100 and 70 mg/ dl) [3] . Underutilization of drugs, poor patient adherence to medication, unawareness of the importance of therapeutic goal attainment, and lack of knowledge with regard to therapeutic goals have been recognized as limitations to patients achieving these goals [9] .…”

“…The basis of developing the study questionnaire was obtained from a study that investigated patients' knowledge of diabetes therapeutic goals, medication adherence, and goal achievement [9] . The questionnaire contained both closed and open-ended questions.…”

Factors determining non-compliance with drug therapy on diabetes patients

“…Según algunos estudios, el grado de conocimiento sobre la enfermedad y la medicación por parte de los pacientes favorece el cumplimiento (19,(25)(26)(27)(28)(29), además de influir en su calidad de vida y grado de satisfacción (30).…”

La diabetes en España desde la perspectiva de la farmacia comunitaria: conocimiento, cumplimiento y satisfacción con el tratamiento

“…El nivel de conocimiento de los pacientes sobre la enfermedad y la medicación influye en el cumplimiento [7][8][9][10][11][12], la calidad de vida y el grado de satisfacción [13], mientras que una baja satisfacción con el tratamiento repercute en el cumplimiento terapéutico, el número de episodios de hipoglucemia y niveles de hemoglobina glicosilada (HbA1c) [14].…”