Better Medication Management Doesn’t Improve Type 2 Diabetes Outcomes

Medical practitioners have long been concerned that patients with diabetes often fail to properly use their medications as prescribed. While reasons for this trend are not well understood, many physicians hope that by focusing more on getting their patients to take their medications correctly, they would achieve improved health outcomes. However, one study has recently found that this is not the case.

About the Study

Researchers from the Regenstrief Institute in Indianapolis recently completed a study to determine if improving adherence to diabetes medication could also improve patients’ health. This was done by examining 96 patients with type 2 diabetes that were being treated in a large healthcare system. Each patient was using, at least, one active prescription, including thiazolidinediones, sulfonylureas, or biguanides. They also had a history of visits with one of the 15 health providers that were participating in the study. Many of the diabetic patients also had co-morbid conditions like hypercholesterolemia or hypertension.

Next, patient data was entered into a “dashboard” type system that was available to the 15 participating providers. This included information about BMI, cholesterol level, HbA1c level, and blood pressure. At baseline, diabetic patients also filled out a questionnaire that was designed to assess any barriers that might prevent them from taking their medication correctly. The questionnaire was repeated every 2-3 months for the duration of the nine-month study.

Findings Show No Significant Differences

After nine months, investigators did not find any significant differences in any parameter that was measured before and after the study. Twenty-four patients completed all of the questionnaires, and it was found that while average HbA1c levels declined slightly, BMI rose.

This study also identified that there were many different reasons why some patients were not taking their medication. Some of the most common included:

  • Not liking to take medication in general
  • Forgetting to take their medication
  • Not being able to afford their medication
  • Wanting to avoid adverse side effects associated with their medication
  • Running out of their medication before they had a chance to call their physician

While type 2 diabetes outcomes did not necessarily improve when patients adhered to taking their medications properly, researchers and medical providers alike are still concerned with overcoming these barriers. It is thought that different types of solutions are needed depending on the obstacle. For example, people who have a difficult time remembering to take their medications might benefit from memory aids.

However, people in the group that simply don’t like to take medication, in general, may be more difficult to reach.

This study found that if physicians’ attention is put on adherence, adherence will go up. However, this has not been shown to result in any changes in clinical outcomes regarding BMI, blood pressure, or HbA1c. Unfortunately, the global prevalence of type 2 diabetes is only continuing to rise, so further research is needed to find out how to improve type 2 diabetes health outcomes.

These findings were published in JMIR Medical Informatics on March 2, 2016.

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