Secondary Prevention by Enhancing Adherence in Diabetic Patients

Objectives: Adherence to prescribed medications is a key dimensionof healthcare quality. Poor medication adherence might be a significantbarrier to achievement of positive clinical outcomes. This study aimedto compare the adherence to oral hypoglycemic agents in patients withtype 2 diabetes by using two methods of completing diary checklist andcollecting drug shells.Methods: This randomized clinical trial was conducted in IsfahanDiabetes Institute. A number of 100 type 2-diabetic patients were selectedthrough systematic sampling method and then were randomlyallocated to two groups of equal number. Each group was invited toattend our 12-week educational program. We asked one group to completediary checklist about how they took their drugs during the studyperiod. The other group was asked to collect the shells of oral hypoglycemicagents after taking in a pocket. Medication adherence ratiowas calculated for both groups.Results: Overall, 87 patients completed the study, of which 30 cases(34.5%) were in the check list group and 57 (65.5%) in the referencegroup. In the check list group, the adherence ratio was good in 96.7%and moderate in 3.3%, with no case of poor adherence. In the referencegroup, the corresponding figures were 55.2%, %6.9 and 37.9%,respectively (p<0.05 between groups).Conclusions: Although the adherence ratio was greater than 80% inboth groups, it was significantly higher in the check list group. Therefore,we suggest that by increasing adherence to prescribed medications,diary checklist can be an effective method of secondary preventionof chronic diseases, as diabetes mellitus.