Singleton Jerica, Veach Stevie, Catney Christine, Witry Matthew
Department of Pharmacy Practice and Science, University of Iowa College of Pharmacy, PGY1 Community Pharmacy Practice at Time of Study, Iowa City, IA 52242, USA.
Department of Pharmacy Practice and Science, University of Iowa College of Pharmacy, Iowa City, IA 52242, USA.
Pharmacy (Basel). 2017 Oct 19;5(4):58. doi: 10.3390/pharmacy5040058.
For patients with diabetes, suboptimal medication adherence contributes to disease progression, complications, and increased healthcare costs. Identification of, and intervention for patient-identified reasons for nonadherence are essential to improving medication adherence. This prospective, quality improvement study was conducted at an independent community pharmacy in the Mid-West United States. Patients with a proportion of days covered (PDC) for their oral antidiabetic medications of less than 80% were contacted by telephone and interviewed by a clinical pharmacist. The interviews and corresponding adherence interventions were guided by an abbreviated version of the Drug Adherence Work-Up (DRAW©) tool that focused on oral medications for diabetes. The change in PDC 120-days post-interview was assessed to determine the change in adherence rates. Patients receiving the pharmacist-delivered adherence intervention had significantly higher 120 day PDC values which are likely to indicate more regular medication-taking at home. Almost half of study patients signed up for medication synchronization and these patients trended toward higher PDC values, although the relative difference was not statistically significant from those receiving the intervention and not opting to have their medications synchronized.
对于糖尿病患者而言,用药依从性欠佳会导致疾病进展、出现并发症并增加医疗成本。识别患者自述的不依从原因并进行干预,对于提高用药依从性至关重要。这项前瞻性质量改进研究在美国中西部的一家独立社区药房开展。口服抗糖尿病药物的覆盖天数比例(PDC)低于80%的患者会接到电话,并由临床药剂师进行访谈。访谈及相应的依从性干预由《药物依从性检查》(DRAW©)工具的简化版指导,该版本聚焦于糖尿病口服药物。评估访谈后120天的PDC变化,以确定依从率的变化。接受药剂师提供的依从性干预的患者,其120天的PDC值显著更高,这可能表明他们在家中服药更规律。近一半的研究患者报名参加了药物同步服务,这些患者的PDC值有升高趋势,不过与接受干预但未选择进行药物同步服务的患者相比,相对差异无统计学意义。