Assessment of medication adherence in type-2 diabetes patients on poly pharmacy and the effect of patient counseling given to them in a multispecialty hospital.

Abstract

Introduction: The ability of physicians to recognize non-adherence is poor and interventions to improve adherence have had mixed results. Furthermore, successful interventions generally are substantially complex and costly. Poor adherence to medication regimens accounts for substantial worsening of disease; death and increased health care costs. The aim of this study is to assess the medication adherence in type-2 diabetes patients who are on polypharmacy and the effect of counseling provided for them in a multispecialty hospital.

Materials and methods: The study was carried out at Kovai Medical Center and Hospital; Coimbatore Tamil Nadu, India. This is a 500-bedded modernized, multi-specialty tertiary care hospital with full-fledged diabetic department. It caters to the needs of both out-patients and in-patients. An assessment was made on type-2 diabetic patients who are receiving more than 5 drugs for their co-morbidities were included in this study. A medication adherence questionnaire was prepared based on the literatures. The study was approved by the Kovai Medical Center and Hospital ethics committee.

Results: Among 240 patients, 124 patients were adherent to medication whereas 116 patients were non-adherent. The non-adherent patients were giving verbal counseling in a private counseling room regarding medication adherence.

Conclusions: Best way health professionals can tackle the adherence problem is through quality patient counseling as done in this study. With limited time most professionals have with a patient today this can be easier said than done. However, techniques such as the ask-educate-ask approach, the teach-back method and motivational interviewing can help ensure patient understanding of the counseling provided.