Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of a pilot study to influence medication adherence of patients with diabetes mellitus type-2 by the pharmacy

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Interventions aimed to increase adherence to drug treatment usually are not tailored to the needs of individual patients. A modular pharmacy intervention, named ‘Support for Diabetes’, was developed to improve adherence to type 2 diabetes treatment. Objective To evaluate the implementation of a new care intervention by using focus groups including pharmacy teams, and assess patient satisfaction. Setting Community pharmacies in The Netherlands Method The intervention comprises a structured patient interview, an intervention guide and modular interventions tailored to the underlying cause of non-adherence. Feasibility was studied in non-adherent type 2 diabetes mellitus patients, and evaluated by means of focus group interviews with pharmacists and pharmacy technicians. Topics included practicability of the patient selection procedure, patient interviews, materials developed for the intervention and general practitioner (GP) co-operation. Patients’ experiences (n = 36) were assessed by means of a questionnaire. Main outcome measure Feasibility of the intervention and patients’ satisfaction. Results Pharmacists and pharmacy technicians considered the intervention feasible and appreciated its pro-active approach. Involvement of pharmacy technicians proved a stimulating factor. Poor co-operation with GPs and lack of time as well as financial compensation were interfering factors. Patients appreciated the intervention and reported to follow the advice of pharmacists. Conclusion The ‘Support for Diabetes’ intervention is feasible to implement in pharmacy practice. Poor co-operation between pharmacists and GPs and lack of re-imbursement are obstructions for implementation on a wider scale. These issues should receive attention of pharmacists, policymakers and researchers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Baan CA, Poos MJJC. Hoe vaak komt diabetes mellitus voor en hoeveel mensen sterven eraan. RIVM 2005.

  2. Herings RMC, et al. Chronische Farmacotherapie Voorgezet—Een onderzoek naar de omvang, determinanten en mogelijke economische consequenties van het vroegtijdig afbreken van chronische farmacotherapie, PHARMO Instituut 2002.

  3. Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence (Review). Cochrane Database Syst Rev. 2008; (2):CD000011.

  4. Ho PM, Rumsfeld JS, Masoudi FA, McClure DL, Plomondon ME, Steiner JF, Magid DJ. Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med. 2006;17:1836–41.

    Article  Google Scholar 

  5. Sabaté E. Adherence to long-term therapies. Evidence for action. Geneva: World Health Organization; 2003.

    Google Scholar 

  6. Lee WC, Balu S, Cobden D, et al. Prevalence and economic consequences of medication adherence in diabetes: a systematic literature review. Manag Care Interface. 2006;19:31–41.

    PubMed  Google Scholar 

  7. Wroe AL. Intentional and unintentional nonadherence: a study of decision-making. J Behav Med. 2002;25:355–72.

    Article  PubMed  Google Scholar 

  8. Lehane E, McCarthy G. Intentional and unintentional non-adherence: a comprehensive framework for clinical research and practice? A discussion paper. Int J Nurs Stud. 2007;44:1468–77.

    Article  PubMed  Google Scholar 

  9. Lowry KP, Dudley TK, Oddone EZ, Bosworth HB. Intentional and unintentional nonadherence to antihypertensive medication. Ann Pharmacother. 2005;39:1198–203.

    Article  PubMed  Google Scholar 

  10. Brown KK, Rehmus WE, Kimball AB. Determining the relative importance of patient motivations for nonadherence to topical corticosteroid therapy in psoriasis. J Am Acad Dermatol. 2006;55:607–13.

    Article  PubMed  Google Scholar 

  11. Hugtenburg JG, Blom ATG, Kisoensingh SU. Initial phase of chronic medication use; patients’ reasons for discontinuation. Br J Clin Pharmacol. 2006;61:352–4.

    Article  PubMed  CAS  Google Scholar 

  12. Vermeire E, Wens J, Van Royen P, et al. Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005; (2):1–37.

  13. Sluijs EM, Van Dulmen S, Van Dijk L, et al. Patient adherence to medical treatment: a meta review. Utrecht: NIVEL; 2006.

    Google Scholar 

  14. Horne R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 1999;47:555–67.

    Article  PubMed  CAS  Google Scholar 

  15. Wong LP. Focus group discussion: a tool for health and medical research. Singapore Med J. 2008;49:256–60.

    PubMed  CAS  Google Scholar 

  16. Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000;320:114–6.

    Article  PubMed  CAS  Google Scholar 

  17. Herborg H, Haugbølle LS, Sørensen L, et al. Developing a generic, individualised adherence programme for chronic medication users. Pharm Pract. 2008;6:148–57.

    Google Scholar 

  18. DiMatteo MR, Haskard-Zolnierek KB, Martin LM. Improving patient adherence: a three-factor model to guide practice. Health Psychol Rev. 2012;6:74–91.

    Article  Google Scholar 

  19. Tinelli M, Ryan M. Bond C Patients’ preferences for an increased pharmacist role in the management of drug therapy. Int J Pharm Pract. 2009;17:275–82.

    Article  PubMed  Google Scholar 

  20. Beney J, Bero LA, Bond C. Expanding the roles of outpatient pharmacists: effects on health services utilisation, costs, and patient outcomes (Cochrane Review). Cochrane Lib. 2001; (2):2003.

  21. Krska J, Cromarty JA, Arris F, et al. Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care. Age Ageing. 2001;30:205–11.

    Article  PubMed  CAS  Google Scholar 

  22. Bernsten C, Bjorkman I, Caramona M, et al. Improving the well-being of elderly patients via community pharmacy-based provision of pharmaceutical care: a multicentre study in seven European countries. Drugs Aging. 2001;18:63–77.

    Article  PubMed  CAS  Google Scholar 

  23. Sellors J, Kaczorowski J, Sellors C, et al. A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients. Can Med Assoc J. 2003;169:17–22.

    Google Scholar 

Download references

Acknowledgments

The four pharmacy teams who participated in the study are acknowledged for their co-operation. The authors received unrestricted grants from Apotex, Regifarm, and the Royal Dutch Association for Pharmacy (KNMP).

Funding

None.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of General Practice, VU University Medical Center, Amsterdam, The Netherlands

    Prem Adhien & Giel Nijpels

  2. EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

    Prem Adhien, Giel Nijpels & Jacqueline G. Hugtenburg

  3. NIVEL, Utrecht, The Netherlands

    Liset van Dijk

  4. Kring Apotheken Nederland, Utrecht, The Netherlands

    Marinke de Vegter

  5. Royal Dutch Association for Pharmacy, Den Haag, The Netherlands

    Marnix Westein

  6. Department of Clinical Pharmacology and Pharmacy, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands

    Jacqueline G. Hugtenburg

Authors
  1. Prem Adhien
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Liset van Dijk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marinke de Vegter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marnix Westein
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Giel Nijpels
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jacqueline G. Hugtenburg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jacqueline G. Hugtenburg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Adhien, P., van Dijk, L., de Vegter, M. et al. Evaluation of a pilot study to influence medication adherence of patients with diabetes mellitus type-2 by the pharmacy. Int J Clin Pharm 35, 1113–1119 (2013). https://doi.org/10.1007/s11096-013-9834-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-013-9834-4

Keywords

Search

Navigation