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 .
MAP study: RCT of a medication adherence program for patients with type 2 diabetes.
OBJECTIVE To evaluate the impact of a community pharmacy-based medication adherence detection and intervention protocol on medication adherence for patients with diabetes . DESIGN R and omized controlled trial . SETTING Four community chain pharmacies in the Seattle , WA , area from April 2008 to October 2009 . PATIENTS Patients with diabetes ( n = 265 ) who were taking oral diabetes medications and late for refills by 6 days or more . INTERVENTION Telephone-initiated adherence support by pharmacists following computer-generated missed refill alerts .  Patients were r and omized at the pharmacy level with pharmacists blinded to r and omization . MAIN OUTCOMES MEASURES Changes in medication adherence ( i.e. , days late at first refill , percent with a refill gap of 6 days or more at first refill , medication possession ratio [ MPR ] at 6 and 12 months ) measured during three time periods . RESULTS Baseline MPR ( previous 12 months ) of oral diabetes medications for study versus control participants was relatively high and similar ( 0.86 and 0.84 , respectively ) . At 12 months , MPR was significantly improved for the study group ( P = 0.004 ) compared with the control group ( difference between groups , P = 0.01 ) . The intervention showed greater effect for patients with baseline MPR less than 80 % ( difference between groups , P = 0.02 ) . The likelihood of MPR above 80 % at the 12-month follow-up for any patient significantly favored the intervention group ( odds ratio 4.77 [ 95 % CI 2.00 - 11.40 ] ) . CONCLUSION A brief missed refill intervention program involving urban community chain pharmacies was effective in achieving improved diabetes medication adherence , particularly among individuals with baseline MPR of 0.80 or less
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 .