Highlights
- •Randomized trial investigating adherence patterns to oral hypoglycemic agents.
- •Three patterns were identified: nonadherence, increasing adherence and adherence.
- •Patient Prioritized Planning interventions showed increased adherence patterns.
Abstract
Aims
To examine patterns of adherence to oral hypoglycemic agents among primary care patients
with type 2 diabetes mellitus and to assess whether these patterns were associated
with baseline intervention allocation, sociodemographic characteristics, and clinical
indicators.
Methods
Adherence patterns were examined by Medication Event Monitoring System (MEMS) caps
at baseline and 12 weeks. Participants (n = 72) were randomly allocated to a Patient
Prioritized Planning (PPP) intervention or a control group. The PPP intervention employed
a card-sort task to identify health-related priorities that included social determinants
of health to address medication nonadherence. Next, a problem-solving process was
used to address unmet needs involving referral to resources. Multinomial logistic
regression examined patterns of adherence in relation to baseline intervention allocation,
sociodemographic characteristics, and clinical indicators.
Results
Three patterns of adherence were found: adherent, increasing adherence, and nonadherent.
Participants assigned to the PPP intervention were significantly more likely to have
a pattern of improving adherence (Adjusted Odds Ratio (AOR)= 11.28, 95% confidence
interval (CI)= 1.78, 71.60) and adherence (AOR=4.68, 95% CI=1.15, 19.02) than participants
assigned to the control group.
Conclusion
Primary care PPP interventions incorporating social determinants may be effective
in fostering and improving patient adherence.
Keywords
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Article info
Publication history
Published online: February 18, 2023
Accepted:
January 31,
2023
Received in revised form:
July 18,
2022
Received:
September 9,
2021
Identification
Copyright
© 2023 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
