Background:
Failure to take medication reduces the effectiveness of treatment leading to increasedmorbidity and mortality. We evaluated the efficacy of a consultation-based intervention tosupport objectively-assessed adherence to oral glucose lowering medication (OGLM)compared to usual care among people with type 2 diabetes.
Methods:
This was a parallel group randomised trial in adult patients with type 2 diabetes andHbA1c[greater than or equal to]7.5% (58 mmol/mol), prescribed at least one OGLM. Participants were allocated to aclinic nurse delivered, innovative consultation-based intervention to strengthen patientmotivation to take OGLM regularly and support medicine taking through action-plans, or tousual care. The primary outcome was the percentage of days on which the prescribed dose ofmedication was taken, measured objectively over 12 weeks with an electronic medicationmonitoringdevice (TrackCap, Aardex, Switzerland). The primary analysis was intention-totreat.
Results:
211 patients were randomised between July 1, 2006 and November 30, 2008 in 13 Britishgeneral practices (primary care clinics). Primary outcome data were available for 194participants (91.9%). Mean (sd) percentage of adherent days was 77.4% (26.3) in theintervention group and 69.0% (30.8) in standard care (mean difference between groups 8.4%,95% confidence interval 0.2% to 16.7%, p = 0.044). There was no significant adverse impacton functional status or treatment satisfaction.
Conclusions:
This well-specified, theory based intervention delivered in a single session of 30 min inprimary care increased objectively measured medication adherence, with no adverse effect ontreatment satisfaction. These findings justify a definitive trial of this approach to improvingmedication adherence over a longer period of time, with clinical and cost-effectivenessoutcomes to inform clinical practice.Trial registrationCurrent Controlled Trials ISRCTN30522359