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MAP study: RCT of a medication adherence program for patients with type 2 diabetes
Peggy Soule Odegard1, Dale B Christensen
1School of Pharmacy, University of Washington, Seattle, USA. podegard@u.washington.edu
Journal of the American Pharmacists Association : Japha
|December 12, 2012
Summary
Community pharmacy interventions effectively improved diabetes medication adherence. A brief missed refill program enhanced medication possession ratio (MPR) for patients with diabetes, especially those with lower baseline adherence.
Area of Science:
- Pharmacoeconomics and Health Outcomes Research
- Clinical Pharmacy and Practice
- Diabetes Mellitus Management
Background:
- Medication adherence is crucial for managing diabetes and preventing complications.
- Community pharmacy-based interventions offer accessible opportunities to improve patient adherence.
- Identifying and addressing medication refill gaps is a key strategy for enhancing adherence.
Purpose of the Study:
- To evaluate the effectiveness of a community pharmacy-based protocol for detecting and intervening in medication non-adherence among diabetic patients.
- To assess the impact of pharmacist-led adherence support on medication possession ratio (MPR) in patients with diabetes.
Main Methods:
- A randomized controlled trial was conducted in four urban community chain pharmacies.
- Patients with diabetes (n=265) on oral medications, identified as late for refills, received telephone-initiated adherence support from pharmacists.
- Medication adherence was measured using MPR at 6 and 12 months.
Main Results:
- The intervention group showed a significant improvement in MPR at 12 months compared to the control group (P=0.01).
- The intervention was particularly effective for patients with a baseline MPR below 80% (P=0.02).
- Patients in the intervention group had a significantly higher likelihood of achieving an MPR above 80% at 12 months (OR 4.77).
Conclusions:
- A brief missed refill intervention program in community pharmacies effectively improved diabetes medication adherence.
- The intervention demonstrated particular benefit for patients with lower baseline medication possession ratios.
- Community pharmacy-based adherence support represents a valuable strategy for optimizing diabetes care.
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