Effect of a Medication Adherence Education Intervention on Clinical Outcomes in Adults with Type 2 Diabetes Mellitus: A Randomized Controlled Trial Study.

Background: Low adherence to Oral Antidiabetic Drugs (OADs) in adults with Type 2 Diabetes Mellitus (T2DM) leads to complications, death, and increased healthcare costs.

Objective: This study aimed to evaluate the effectiveness of medication adherence education interventions for the clinical outcomes of adults with T2DM.

Materials and methods: Seventy adults with T2DM from an outpatient clinic in the City of Ardabil, Iran, participated in this study. The participants were randomized into an intervention group (n=35) or a non-interventional group (n=35). The intervention group underwent four educational sessions focused on adherence to OADs. Content within classes was influenced by a participant's Stage of Change (SOC) result, which was related to behavior change modeling. Participants in the non-interventional group were placed on a waiting list to receive educational content after the follow- up. Assessments were conducted at baseline, four weeks, and six months.

Results: Significant improvements in Fasting Plasma Glucose (FPG) (P = 0.018) and 2-hour Plasma Glucose (2-hPG) (P < 0.001) levels were found in the intervention group compared to the noninterventional group post-intervention. Additionally, HbA1C was significantly lower at follow-up in the intervention group than in the non-intervention group (P < 0.001). The Homeostasis Model of Insulin Resistance Assessment (HOMA-IR) revealed a significant increase in target cell sensitivity to insulin in the intervention group compared to that in the non-interventional during the follow- up period (P = 0.009). The SOC for adherence to OADs was significantly improved in the intervention group compared to that in the non-intervention group at the follow-up timepoint (P< 0.001).

Conclusion: Medication adherence education interventions may improve the clinical outcomes of adults with T2DM.