ABSTRACT
AIMS: To assess levels and correlates of adherence to hypoglycaemic medication among patients offered organised general practice diabetes care. METHODS: 60 patients prescribed oral hypoglycaemic medication were recruited to a two-month prospective study. Prescribed doses taken and days on which the prescribed number of doses was taken were measured by MEMS (Medication Event Monitoring System). RESULTS: Overall 99.1% of prescribed doses were taken (median, IQR: 96.8-100%), this was inversely correlated with daily dose frequency (Spearman's rho=0.37, p=0.004). Only 4 patients (6.7%) took less than 90% of prescribed doses. The prescribed dose was taken on 96.4% of days (median, IQR: 89.1-98.2%), this was correlated with age (rho=0.26, p=0.047) and inversely correlated with HbA(1c) levels (rho=-0.29, p=0.02) and daily dose frequency (rho=-0.33, p=0.009). Adherence to metformin was less than to other hypoglycaemic medication (Z=-3.48, p=0.0005). CONCLUSIONS: A dispensing practice with a well-run diabetes service can support high rates of adherence to hypoglycaemic medication. Before changing medication, low adherence might be considered as a possible cause of progressive hyperglycaemia, particularly among patients prescribed metformin more than once a day. Selective monitoring with MEMS may have a clinical as well as a research role in such people.
Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/administration & dosage , Medication Adherence/statistics & numerical data , Metformin/administration & dosage , Primary Health Care/statistics & numerical data , Sulfonylurea Compounds/administration & dosage , Administration, Oral , Aged , Ambulatory Care Facilities/statistics & numerical data , Diabetes Complications/prevention & control , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
Further development of a strong research base for general practice is important if the profession is to respond appropriately to its central role in service provision. It can be difficult for general practitioners (GPs) who have not pursued an academic career path to make a significant contribution to research. The development of a service-academic partnership is described, together with an honest account of the difficulties encountered.
