Diabetes Studies
Medication Adherence
Patient Compliance Prescription Drug Compliance a Significant Challenge for Many Patients
Nearly two-thirds (64%) of 2,507 US adults report that they have simply forgotten to take their medication, with 11 percent saying that this has happened "often" or "very often."
Harris Interactive/The Wall Street Journal March 29, 2005
Online Survey
http://www.harrisinteractive.com/news/allnewsbydate.asp?NewsID=904
The Price of Non-Compliance
The least compliant diabetes patients were more than twice as likely to be hospitalized compared to those who were most compliant, and their total health-care costs were nearly double. The study notes that people who use their diabetes medications as directed are less likely to develop the short-term and long-term health problems that can require expensive care. For diabetes, every additional dollar spent on medication saved $7 in medical costs. The combined drug and medical costs for the most-compliant diabetes patients average $4,570, which is almost 50 percent below the $8,867 cost for the least-compliant group.
Human Resource Executive, May 2, 2006 Tom Starner
From the Medco Study on Diabetic Non-Compliance, 2005, Dr. Robert Epstein
http://www.hreonline.com/HRE/story.jsp?storyId=5059249
A nurse short message service by cellular phone in type-2 diabetic patients for six months
The web-based intervention using SMS messaging improved levels of HbA1c and 2HPMG in type-2 diabetic patients for the six-month duration of the trial.
Journal of Clinical Nursing, June, 2007, Vol. 16 No. 6, pp 1082-1087
Hee-Seung Kim, Ph.D., RN; Hye-Sun Jeong PhD, RN
Control group pre-test-post-test design
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2702.2007.01698.x?journalCode=jcn
The Asheville Project: long-term clinical and economic outcomes of a community pharmacy diabetes care program
This study was designed to assess the persistence of outcomes for up to 5 years following the initiation of the The Asheville Project, a program of community-based pharmaceutical care services (PCS) for patients with diabetes. Mean A1c decreased at all follow-ups, with more than 50% of patients demonstrating improvements at each time. The number of patients with optimal A1c values (< 7%) also increased at each follow-up. More than 50% showed improvements in lipid levels at every measurement. Costs shifted from inpatient and outpatient physician services to prescriptions, which increased significantly at every follow-up. Total mean direct medical costs decreased by $1,200 to $1,872 per patient per year compared with baseline. Patients with diabetes who received ongoing PCS maintained improvement in A1c over time, and employers experienced a decline in mean total direct medical costs.
Journal of the American Pharmaceutical Association 2003 Mar-Apr;43(2):173-84
Barry A. Bunting and Carole W. Cranor, DB Christensen (
Comparative Study)
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=
12688435&ordinalpos=2&itool=EntrezSystem |
HIV/AIDS Studies
Medication Adherence
Patient Compliance Mobile Phone Reminders
The Use of Cell Phone (Mobile Phone) Reminder Calls for Assisting HIV-Infected Adolescents and Young Adults to Adhere to Highly Active Antiretroviral Therapy: A Pilot Study.
In the first 4 weeks of the study when calls were daily, very few phone calls or medications were reported missed. In the following 4 weeks were calls were tapered to weekdays only, few calls and few medications were missed. Overall, the subjects that did not experience institutionalization or major chaotic life changes did very well receiving phone calls, and did well with adherence to medication doses.
AIDS Patient Care and STDs, Volume 20, Number 6, 2006, pp 438-444
Joseph A. Puccio, M.D., Marvin Belzer, M.D., Johanna Olson, M.D., Miguel Martinez, M.P.H., Cathy Salata, R.N., Diane Tucker, R.N., And Diane Tanaka, M.D. (Cohort Prospective)
http://direct.bl.uk/bld/PlaceOrder.do?UIN=189507263&ETOC=RN&from=searchengine
HAART Study
Simply forgot is the most frequently stated reason for missed doses of HAART irrespective of degree of adherence.
Some of the most effective behavioral strategies include tailoring the medical regimen to the patient's daily routine and lifestyle. A final intervention found to be quite successful in improving and maintaining high levels of adherence to medical recommendations is that of social support, either from a health care professional or within one's personal environment.
HIV Medicine, Volume 7 Issue 5 Pages 285-290, July 2006
TS Barfod, HT Sørensen, H Nielsen, L Rodkjær and N Obe
Cohort Study
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1468-1293.2006.00387.x?journalCode=hiv
Leason learned from HEART
Overview and implementation of an intervention to prevent adherence failure among HIV-infected adults initiating antiretroviral therapy: Lessons learned from Project HEART
Few participants eligible for the study had trouble identifying a support partner. Over 90% of support partners attended at least one intervention visit. Support partners were most available and amenable to participate early in the initiation of therapy. Participants' experiences as the 'supported' partner were generally positive. Though many participants faced barriers not easily addressed by this intervention (for example, housing instability), formally integrating support partners into the intervention helped to address many other common adherence barriers. Family and friends are an underutilized resource in HIV medication adherence. Enlisting the help of support partners is a practical and economical approach to adherence counselling.
AIDS Care, Volume 18 Issue 8 Pages 895-903, November 2006
G. Davies; L.J. Koenig; D. Stratford; M. Palmore; T. Bush; M. Golde E. Malatino; M. Todd-Turner; T. V. Ellerbrock (prospective controlled study)
http://www.informaworld.com/smpp/content~content=a757706749~db=all |
Schizophrenia Medication Compliance Patient Adherence A Comparison of the Effects of Computer and Manual Reminders on Compliance with a Mental Health Clinical Practice Guideline
The results of this study clearly demonstrate that in an outpatient mental health clinic, computer reminders were shown to be superior to manual reminders in improving adherence to a clinical practice guideline for depression
JAMIA, 2000;7:196–203 Dale S. Cannon and Steven N. Allen
Independent, randomized controlled study: http://www.jamia.org/cgi/content/abstract/7/2/196
Factors Influencing Compliance in Schizophrenia Patients
The therapeutic relationship that a clinician builds with his or her patient is a cornerstone
of treatment compliance. The most important factor influencing compliance was the
patient’s perception of the doctor’s interest in him or her, which is clearly reinforced by the amount of time that physicians spend with their patients. Such a relationship is a
prerequisite for a working therapeutic alliance, and providing reliable information is a
crucial factor in this context. Information can be given to patients and their relatives or
significant others, either informally during scheduled visits or in psychoeducational
groups. Providing information includes discussing treatment plans regularly with patients
and their significant others, which gives both an active part in the treatment planning process.
J Clin Psychiatry 2003;64[suppl 16]:10–13) W. Wolfgang Fleischhacker; Maria A. Oehl; and Martina Hummer
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&
TermToSearch
=14680413&ordinalpos=1&itool=EntrezSystem2.PEntrez.
Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum |