Impact on medication use and adherence of Australian pharmacists' diabetes care services.
OBJECTIVE
To assess the effect of a specialized service implemented in community pharmacies for patients with type 2 diabetes on medication use and medication-related problems.


METHODS
Parallel group, multisite, control versus intervention, repeated measures design, with three different regions in New South Wales, Australia, used as intervention regions, then matched with control regions as much as possible.


METHODS
After initial training, pharmacists followed a clinical protocol for more than 9 months, with patient contact approximately monthly. Each patient received an adherence assessment at the beginning and end of the study, adherence support, and a medication review as part of the intervention.


METHODS
Risk of nonadherence using Brief Medication Questionnaire (BMQ) scores and changes to medication regimen.


RESULTS
Compared with 82 control patients, 106 intervention patients with similar demographic and clinical characteristics had significantly improved self-reported nonadherence as reflected in total BMQ scores after 9 months. The mean (+/-SD) number of medications prescribed at follow-up in intervention participants decreased significantly, from 8.2+/-3.0 to 7.7+/-2.7. No reduction was observed among the control patients (7.6+/-2.4 and 7.3+/-2.4). The overall prevalence of changes to the regimen was also significantly higher in the intervention group (51%) compared with controls (40%).


CONCLUSIONS
Community pharmacists trained in medication review and using protocols in collaboration with providers improved adherence in patients with type 2 diabetes, reduced problems patients had in accessing their medications, and recommended medication regimen changes that improved outcomes.
Krass
Ines
I
Faculty of Pharmacy, University of Sydney, Camperdown, New South Wales, Australia. inesk@pharm.usyd.edu.au
Taylor
Susan J
SJ
Smith
Carlene
C
Armour
Carol L
CL
D001315:Australia; D002908:Chronic Disease; D003157:Community Pharmacy Services / Q000592:standards; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D016903:Drug Monitoring / Q000379:methods / Q000706:statistics & numerical data; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010347:Patient Care Planning / Q000592:standards; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010595:Pharmacists / Q000592:standards*; D011795:Surveys and Questionnaires / Q000145:classification; D016896:Treatment Outcome