Effect of Medication Related Educational Interventions on Improving Medication Adherence in Patients With Type 2 Diabetes Mellitus

Abstract

Objectives: To assess the patient medication adherence using 8 item morisky medication adherence scale (MMAS). To categorize patients based on their adherence to antidiabetic medications into low, medium, and high adherent. To provide educational interventions such as patient counseling using teach-back method, patient medication information leaflet, and audio-visual aids and thus to improve the patient medication adherence. Methods:After obtaining informed consent from the patients, data of the patients were recorded in data collection forms. Their adherence to antidiabetic medication was evaluated using 8 item MMAS and patients were categorized into low, medium, and high adherence groups based on the score. Counseling was done based on the categorization (high, medium, and low). During review, again adherence was rechecked using 8 item MMAS.Results: Medication adherence was measured using 8 item MMAS on review and adherence was found to be improved using different patient counseling methods according to their adherence category. Improvement in score within low adherence group was found to be 83.87%; improvement of the low adherence group to medium adherence group was 16.12%. Improvement within the medium adherence group was 82.14% and from medium adherence to high adherence group was 17.85%. Conclusion:Patient counseling can improve adherence in type 2 diabetes mellitus patients, which in turn help patients in achieving optimal glycemic control.

Teach-back: A systematic review of implementation and impacts

“…This teach-back enhanced education ranged from brief sessions to more complex training. Nine studies [38,41,43,46,48,49,51,53,54] comprised more than one education session over the study period (range 2-11); brochures or written information were given in five studies [39,42,47,53,57] to aid the teach-back process; and demonstration of a technique was used in two studies [47,55]. There were four studies in which teach-back was delivered as a less structured approach; two of these focused on training clinicians to use teach-back as part of their routine care [31,40], and two studies [44,56] trained nursing staff to use teach-back when providing discharge instructions in the ED (Table 2).…”

“…Of the 20 included studies, only 10 [39, 40, 44, 48, 51-54, 56, 57] reported sufficient information regarding implementation of teach-back. Of the remaining 10 studies, three [42,45,50] did not report any details related to implementation and seven [38,41,43,46,47,49,55] delivered teach-back via research staff, meaning that implementation strategies were not relevant in clinical practice, but for research purposes only (Table 2).…”

“…Most studies were conducted among participants with chronic conditions (n = 12). Studies that included participants with Type II diabetes reported significant improvements in medication adherence [42,53], diet changes [53] and foot self-care [49] following teach-back compared to usual care control groups. The two studies in heart failure patients measured hospital re-admissions, with both studies reporting a minor reduction in re-admission rates [45,54].…”

Analisis Determinan Faktor-Faktor yang Berhubungan dengan Kepatuhan Minum Obat Pasien Diabetes Tipe 2 di Pelayanan Kesehatan Primer

“…Upaya yang dapat dilakukan untuk meningkatkan kepatuhan diantaranya menurunkan kompleksitas terapi seperti mengurangi frekuensi minum obat dan menggunakan kombinasi pengobatan dalam satu obat (fixed dose combination pill) dan edukasi tentang penyakit dan obat [1,33]. Farmasis ikut berperan dalam kepatuhan minum obat dan sudah banyak penelitian yang menunjukkan bahwa konseling farmasis dapat membantu meningkatkan kepatuhan minum obat [34][35][36][37].…”