Adherence in diabetes patients
BMC Family Practice 2012;13:30
A single 30-minute session led by nurses increases adherence among patients with type-2 diabetes mellitus.
Researchers enrolled 211 adults with type-2 diabetes mellitus from 13 British general practices. All patients showed HbA1c =7.5% (=58 mmol/mol) and received at least one oral glucose lowering medication.
A total of 85 patients received standard care. The other 126 patients attended sessions run by trained clinic nurses who elicited patients' beliefs that could affect adherence, such as: perceived benefits and harms; views of other people; and other factors that may facilitate or inhibit adherence.
The nurses also reinforced positive beliefs verbally and by offering tailored information, while tackling negative beliefs using a 'problem solving' approach. Nurses then asked patients to write down where, when and how they would take their medication using 'if-then' questions.
Based on electronic monitoring of the number of times the bottle was opened, patients who attended the nurse-led clinic were adherent on average, 77.4% of days during the 12-week follow up.
This compared to 69% of days with standard care, a statistically significant difference. Attending the clinic did not undermine functional status, patient satisfaction or communication, or increase hypoglycaemia rates.