Does intervention by an allied health professional discussing adherence to medicines improve this adherence in Type 2 diabetes?
OBJECTIVE
Increasing adherence to medicines should improve glycaemic control and be cost effective in patients with Type 2 diabetes. It is assumed that the intervention of an allied health professional will improve adherence to medicines, but this has not been well documented. The aim of this review was to determine whether an intervention by an allied health professional, including a discussion of adherence to medicines, improved adherence to medicines in these subjects.


METHODS
A comprehensive review of the literature was undertaken to determine this. All available studies were included and critically reviewed.


RESULTS
When adherence to medicines was high in the treatment of Type 2 diabetes, an intervention by an allied health professional did not improve adherence. In studies in which the adherence could be improved the results were varied, with some studies showing improvement and some not. This variation existed whether the allied health professional was a nurse, a pharmacist or a diabetes educator, and whether the intervention was by phone or by counselling in person.


CONCLUSIONS
In conclusion, prior to undertaking an intervention to improve adherence to medicines in Type 2 diabetes, it is necessary to know the baseline level of adherence, and if adherence is already high there is no point in undertaking an intervention. When adherence to medicines is low, it is not clear which interventions will improve adherence, and further studies are needed to clarify this.
Discipline of Medical Sciences, Faculty of Science and Technology, Queensland University of Technology, Gardens Point, GPO2434, QLD4001, Australia. sheila.doggrell@qut.edu.au
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Doggrell
D000488:Allied Health Personnel; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017010:Reminder Systems
D007004:Hypoglycemic Agents