A systematic review of interventions to improve adherence to diabetes medications within the patient-practitioner interaction

Antoinette Schoenthaler, Yendelela Cuffee

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

• Objectives: To conduct a systematic review of the literature examining interventions delivered by health care practitioners to improve medication adherence in patients with diabetes mellitus (DM). • Methods: Databases were searched up to 2 July 2013 to identify eligible studies that included interventions that were conducted in a clinic-based setting and delivered by a health care practitioner (eg, nurse, physician, diabetes educator) to improve adherence to diabetes medications (including oral hypoglycemic agents and insulin). Articles were limited to published clinical trials conducted in adults ≥ 18 years of age and published in English-language journals. • Results: 18 papers were reviewed: 15 trials targeted patients with DM, 3 targeted health care practitioners. 7 patient-focused and 1 practitioner-focused trial demonstrated a beneficial effect of the intervention compared with a control group. The patient-focused trials were complex interventions involving a combination of adherence-enhancing strategies such as individualized patient counseling, tailored patient education, medication reminders, behavioral feedback and reinforcement, and care management by ancillary staff, nurses, text message or telephone-linked system. The practitioner-focused trial employed an electronic feedback system for individualized care and quality improvement. Limitations included the diversity in the measures employed to assess adherence; differing definitions of adherence; the inclusion of patients regardless of baseline adherence status; and the short duration of the trials. • Conclusions: Additional research is needed to understand the conditions under which interventions targeting the patient-practitioner interaction can be implemented in clinic settings to improve medication adherence in patients with DM.

Original languageEnglish (US)
Pages (from-to)494-506
Number of pages13
JournalJournal of Clinical Outcomes Management
Volume20
Issue number11
StatePublished - Jan 1 2013

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Diabetes Mellitus
Medication Adherence
Delivery of Health Care
Communication Aids for Disabled
Text Messaging
Nurse Practitioners
Patient Education
Quality Improvement
Hypoglycemic Agents
Counseling
Language
Nurses
Clinical Trials
Databases
Insulin
Physicians
Control Groups
Research
Reinforcement (Psychology)

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

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abstract = "• Objectives: To conduct a systematic review of the literature examining interventions delivered by health care practitioners to improve medication adherence in patients with diabetes mellitus (DM). • Methods: Databases were searched up to 2 July 2013 to identify eligible studies that included interventions that were conducted in a clinic-based setting and delivered by a health care practitioner (eg, nurse, physician, diabetes educator) to improve adherence to diabetes medications (including oral hypoglycemic agents and insulin). Articles were limited to published clinical trials conducted in adults ≥ 18 years of age and published in English-language journals. • Results: 18 papers were reviewed: 15 trials targeted patients with DM, 3 targeted health care practitioners. 7 patient-focused and 1 practitioner-focused trial demonstrated a beneficial effect of the intervention compared with a control group. The patient-focused trials were complex interventions involving a combination of adherence-enhancing strategies such as individualized patient counseling, tailored patient education, medication reminders, behavioral feedback and reinforcement, and care management by ancillary staff, nurses, text message or telephone-linked system. The practitioner-focused trial employed an electronic feedback system for individualized care and quality improvement. Limitations included the diversity in the measures employed to assess adherence; differing definitions of adherence; the inclusion of patients regardless of baseline adherence status; and the short duration of the trials. • Conclusions: Additional research is needed to understand the conditions under which interventions targeting the patient-practitioner interaction can be implemented in clinic settings to improve medication adherence in patients with DM.",
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A systematic review of interventions to improve adherence to diabetes medications within the patient-practitioner interaction. / Schoenthaler, Antoinette; Cuffee, Yendelela.

In: Journal of Clinical Outcomes Management, Vol. 20, No. 11, 01.01.2013, p. 494-506.

Research output: Contribution to journalReview article

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