Secondary Prevention by Enhancing Adherence in Diabetic Patients

OBJECTIVES: Adherence to prescribed medications is a key dimension of healthcare quality. Poor medication adherence might be a significant barrier to achievement of positive clinical outcomes. This study aimed to compare the adherence to oral hypoglycemic agents in patients with type 2 diabetes by using two methods of completing diary checklist and collecting drug shells. METHODS: This randomized clinical trial was conducted in Isfahan Diabetes Institute. A number of 100 type 2-diabetic patients were selected through systematic sampling method and then were randomly allocated to two groups of equal number. Each group was invited to attend our 12-week educational program. We asked one group to complete diary checklist about how they took their drugs during the study period. The other group was asked to collect the shells of oral hypoglycemic agents after taking in a pocket. Medication adherence ratio was calculated for both groups. RESULTS: Overall, 87 patients completed the study, of which 30 cases (34.5%) were in the check list group and 57 (65.5%) in the reference group. In the check list group, the adherence ratio was good in 96.7% and moderate in 3.3%, with no case of poor adherence. In the reference group, the corresponding figures were 55.2%, %6.9 and 37.9%, respectively (p<0.05 between groups). CONCLUSIONS: Although the adherence ratio was greater than 80% in both groups, it was significantly higher in the check list group. Therefore, we suggest that by increasing adherence to prescribed medications, diary checklist can be an effective method of secondary prevention of chronic diseases, as diabetes mellitus.