The review found that multifaceted interventions , addressing several non-adherence factors , were comparatively more effective in improving medication adherence and glycaemic target in patients with T2D than single strategies .
However , interventions with similar components and those addressing similar non-adherence factors demonstrated mixed results , making it difficult to conclude on effective intervention strategies to promote adherence .
Educational strategies have remained the most popular intervention strategy , followed by behavioural , with affective components becoming more common in recent years .
There is a noticeable shift in the literature from using single to multifaceted intervention strategies addressing a range of factors impacting adherence to medications .
BACKGROUND Poor adherence to anti-diabetic medications contributes to suboptimal glycaemic control in patients with type 2 diabetes ( T2D ) .
A range of interventions have been developed to promote anti-diabetic medication adherence .
However , there has been very little focus on the characteristics of these interventions and how effectively they address factors that predict non-adherence .
In this systematic review we assessed the characteristics of interventions that aim ed to promote adherence to anti-diabetic medications .
Effectiveness of a community pharmacist intervention in diabetes care: a randomized controlled trial.
WHAT IS KNOWN AND OBJECTIVE There is little evidence from well- design ed r and omized controlled trials of the impact of community pharmacist intervention on the clinical management of patients with type 2 diabetes . It is also not known how sustainable any observed effects on glycaemic control are , over time . This study was initiated to address both these issues . METHODS A 6-month , r and omized , controlled parallel-group trial in 66 community pharmacies was conducted in Belgium . Patients were r and omly assigned to receive usual pharmacist care ( n = 135 ) or a predefined pharmacist intervention ( n = 153 ) . The intervention mainly focused on correct medication use , medication adherence and healthy lifestyle promotion . Primary outcome was glycaemic control , as measured by fasting plasma glucose and HbA1c . Sustainability of changes in glycaemic control was assessed by additional glucose measurements 18 months after the end of the study . RESULTS AND DISCUSSION The intervention significantly reduced HbA1c ( between-group difference : 0·5 % , P = 0.009 ) . The largest impact on HbA1c was observed when pharmacotherapy changes ( i.e. , type and /or dose of hypoglycaemic agents ) initiated by the physician were sustained with pharmaceutical care : HbA1c was reduced by 1·05 % in the intervention group , whose medication was changed , compared with a reduction of 0·02 % in the therapy-modification only , group . It was also found that the diabetes education program result ed in improved self-management and better knowledge of diabetes . Eighteen months after the end of the formal study period , the mean HbA1c of the intervention group did not differ significantly from the control group ( 7·4 % vs. 7·2 % ) . WHAT IS NEW AND CONCLUSION This study provides new evidence , from a r and omized controlled trial , of the beneficial  effect of community pharmacist intervention in the clinical management of type 2 diabetic patients . However , questions remain about the sustainability of the observed improvements
The review found that multifaceted interventions , addressing several non-adherence factors , were comparatively more effective in improving medication adherence and glycaemic target in patients with T2D than single strategies .
However , interventions with similar components and those addressing similar non-adherence factors demonstrated mixed results , making it difficult to conclude on effective intervention strategies to promote adherence .
Educational strategies have remained the most popular intervention strategy , followed by behavioural , with affective components becoming more common in recent years .
There is a noticeable shift in the literature from using single to multifaceted intervention strategies addressing a range of factors impacting adherence to medications .
BACKGROUND Poor adherence to anti-diabetic medications contributes to suboptimal glycaemic control in patients with type 2 diabetes ( T2D ) .
A range of interventions have been developed to promote anti-diabetic medication adherence .
However , there has been very little focus on the characteristics of these interventions and how effectively they address factors that predict non-adherence .
In this systematic review we assessed the characteristics of interventions that aim ed to promote adherence to anti-diabetic medications .