Improving adherence and reducing medication discrepancies in patients with diabetes

Area of Science:

• Clinical Pharmacy
• Health Services Research
• Patient Adherence

Background:

• Medication adherence is crucial for managing chronic conditions like type 2 diabetes.
• Identifying and addressing medication discrepancies is vital for patient safety and treatment efficacy.
• Previous interventions have focused on patient-reported barriers, but the role of medical record accuracy is less understood.

Purpose of the Study:

• To assess the impact of a pharmacist-led intervention on self-reported medication adherence barriers.
• To identify and quantify medication discrepancies between physician-prescribed and patient-reported regimens.
• To evaluate the effectiveness of the intervention in improving adherence and resolving discrepancies.

Main Methods:

• Prospective, randomized, controlled trial conducted at an academic community health center.
• Eligible patients with type 2 diabetes received a pharmacist intervention including questionnaires, education, and barrier/discrepancy summaries.
• Adherence rates, barriers, and medication discrepancies were assessed at baseline and 3-month follow-up.

Main Results:

• Self-reported medication adherence was already high (6.9/7 days) and did not significantly improve post-intervention.
• Medication regimen discrepancies were found in 44% of intervention patients.
• Sixty percent of discrepancies were resolved by medical record corrections, versus 7% by patient corrections.

Conclusions:

• The pharmacist intervention did not significantly reduce adherence barriers or improve self-reported adherence in this cohort.
• High rates of medication discrepancies were primarily attributed to medical record inaccuracies rather than patient errors.
• Future interventions should consider addressing systemic issues within medical records to improve medication accuracy.