title: Strategies to Improve Medication Adherence Reported by Diabetes Patients and Caregivers: Results of a Taking Control of Your Diabetes Survey.
abstract: BACKGROUND
  Published studies assessing specific methods that patients with diabetes and their caregivers perceive as helpful means of increasing medication adherence are lacking.
  
  
  OBJECTIVE
  To determine methods that patients with diabetes and their caregivers have used to improve medication adherence, investigate the perceived helpfulness of these methods, and identify motivating factors and medication characteristics that may positively influence adherence.
  
  
  METHODS
  A cross-sectional survey was distributed to patients with diabetes and caregivers of patients with diabetes at the 11th annual Taking Control of Your Diabetes conference in October 2005 at the San Diego Convention Center. Outcome measures were self-reported medication adherence, perceived helpfulness of methods employed to improve adherence, motivating factors that may improve adherence, and medication characteristics that may improve adherence.
  
  
  RESULTS
  A total of 524 (40.5% response rate) questionnaires were included in the final analysis, 357 from patients with diabetes and 167 from caregivers. Taking medications as part of a daily routine and using pill boxes were the most frequently reported helpful methods for improving medication adherence. The 3 motivating factors most commonly identified as improving medication adherence were: knowing that diabetes medications work effectively to lower blood glucose, knowing how to manage medication adverse effects, and understanding medication benefits. Many participants thought that newer injectable diabetes medications resulting in weight loss or no additional blood glucose monitoring would be helpful in optimizing adherence.
  
  
  CONCLUSIONS
  Participants in this study identified medication education as a key factor in improving adherence. To empower patients to overcome medication adherence barriers, pharmacists could perform more proactive and thorough counseling sessions that include education on indication, mechanism of action, and therapeutic effects of drugs. They could recommend that patients take medications concurrently with a daily routine and use a pill box, as these actions were reported to be likely to improve medication adherence. However, our results also remind us that motivating factors and tools that may improve adherence may be very patient specific and that pharmacists should incorporate an assessment of this variance in their counseling sessions.
authors.affiliation: Candis M Morello PharmD CDE FCSHP, Associate Professor of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California-San Diego, La Jolla, CA; Ambulatory Care Pharmacist Specialist, Veterans Affairs of San Diego Healthcare System, San Diego, CA candismorello@ucsd.edu.
authors.forename: Candis M
authors.initials: CM
authors.lastname: Morello
authors.affiliation: Megan Chynoweth PharmD, at time of writing, PharmD student, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California-San Diego; now, Pharmacy Practice Resident, Kaiser Permanente, Kern County, CA.
authors.forename: Megan
authors.initials: M
authors.lastname: Chynoweth
authors.affiliation: Hoim Kim PharmD, at time of writing, Pharmacy Practice Resident, University of California, San Diego Medical Center; now, Clinical Pharmacist, City of Hope National Medical Center, Duarte, CA.
authors.forename: Hoim
authors.initials: H
authors.lastname: Kim
authors.affiliation: Renu F Singh PharmD, Associate Clinical Professor, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California-San Diego.
authors.forename: Renu F
authors.initials: RF
authors.lastname: Singh
authors.affiliation: Jan D Hirsch BPharm PhD, Associate Professor of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California-San Diego; Clinical Pharmacist Specialist, Veterans Affairs of San Diego Healthcare System.
authors.forename: Jan D
authors.initials: JD
authors.lastname: Hirsch
mesh_terms: D000368:Aged; D001786:Blood Glucose; D017028:Caregivers; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D057566:Self Report; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose