Effect of a home medication review program on medication adherence, HbA1c, fasting blood sugar, blood pressure, and lipid profiles in patients with type 2 diabetes mellitus: a randomized controlled trial.

• Main Authors: Alias, Nor Elina, Zin, Che Suraya, Ball, Patrick
• Format: Conference or Workshop Item
• Language: English
• Published: 2014
• Subjects: RS Pharmacy and materia medica
• Online Access: http://irep.iium.edu.my/38907/1/fapa_sabah_1.pdf; http://irep.iium.edu.my/38907/
• Institution: Universiti Islam Antarabangsa Malaysia

Poor medication adherence diminishes the health benefits of pharmacotherapies. Patients with Type 2 Diabetes Mellitus (T2DM) require treatment with multiple medications, placing them at increased risk for nonadherence. This study aimed to investigate the efficacy of a home medication review program conducted by a pharmacist to improve medication adherence and its associated effects on HbA1c, fasting blood sugar (FBS), blood pressure (BP), and lipid profiles. Methods: Adult patients with T2DM attending health clinics in rural area of Pahang, Malaysia were recruited into this six months randomized-controlled study. Patients were taking medications for diabetes for at least two years, with HbA1c>8%. The intervention group received three home visits by a pharmacist (at baseline, 3 months and at 6 months) in addition to the standard medical care. Counselling on medication and disease was provided during the visit. Control group patients only received standard medical care. Outcome measures include medication adherence using Modified Morisky adherence scale, HbA1c, fasting blood sugar (FBS), blood pressure (BP) and lipid profiles. Results 73 patients were recruited and randomized into the intervention group (38) and the control group (35), with no significant difference identified in baseline parameters. There was significant improvement in medication adherence from baseline to 6 months in the intervention group (mean difference (MD)=-2.19, 95% CI[-2.73,-1.65], p<0.001) and was associated with significant improvements in HbA1c (mean difference (MD) = 1.57, 95% CI[0.88, 2.26], p<0.001); FBS (MD=2.76, 95% CI[0.59,4.94], p=0.009); systolicBP (MD=6.56, 95% CI[0.75,12.36], p=0.022); diastolicBP (MD=4.44, 95% CI[1.11,7.78], p=0.006); and triglycerides (MD=0.59, 95% CI[0.24,0.93], p<0.001). The control group showed no significant changes in medication adherence (MD=-0.29, 95% CI[-0.89,0.32], p=0.342) and other associated measures. Conclusions A HMR program conducted by a pharmacist provided significant improvement in medication adherence and its associated measures amongst patients with Type 2 diabetes.