Interventions to improve adherence to medication in people with type 2 diabetes mellitus: a review of the literature on the role of pharmacists.
OBJECTIVE
Pharmacists are now adopting a crucial role in the management of chronic illness in primary care, providing diabetes care and advice. This review aims to show whether a range of diabetes care interventions delivered by pharmacists is successful in improving adherence to medication.


METHODS
The studies reviewed formed a subgroup of a Cochrane review on interventions to improve adherence to medication in people with type 2 diabetes. Search terms were 'type 2 diabetes mellitus' and 'compliance' or 'adherence'. Studies were included if they assessed adherence to medical treatment specifically, rather than other aspects of self-management. Out of the 21 studies selected for review, five described an intervention delivered by a pharmacist.


CONCLUSIONS
Two studies reported on attempts to improve adherence focused on the taking of medication. A system of reminders and packaging improved medication adherence, but measuring medicine taking through pill counts or Medication Event Monitoring System was not effective. Three studies evaluated pharmacist-led integrated management and education programmes designed to improve glycaemic control for under-served patient populations. They all succeeded in lowering glycated haemoglobin, but it remains unclear whether this resulted from improved patient adherence.


CONCLUSIONS
This review indicates a potential benefit of pharmacist interventions to improve medication adherence in diabetes, especially in providing patient education.
Lindenmeyer
A
A
Centre for Primary Health Care Studies, Warwick Medical School, University of Warwick Coventry, UK. antje.lindenmeyer@warwick.ac.uk
Hearnshaw
H
H
Vermeire
E
E
Van Royen
P
P
Wens
J
J
Biot
Y
Y
D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D018802:Patient-Centered Care; D010593:Pharmaceutical Services; D016032:Randomized Controlled Trials as Topic; D014481:United States
D007004:Hypoglycemic Agents