Diabetes: Medication Adherence Improves with Information, Motivation and Skills

Chandra Y. Osborn, PhD, MPH Assistant Professor of Medicine & Biomedical Informatics Division of General Internal Medicine & Public Health Center for Health Services Research Vanderbilt University Medical Center  Nashville, TN 37232-8300MedicalResearch.com Interview with:
Chandra Y. Osborn, PhD, MPH

Assistant Professor of Medicine & Biomedical Informatics
Division of General Internal Medicine & Public Health
Center for Health Services Research
Vanderbilt University Medical Center
Nashville, TN 37232-8300

MedicalResearch.com: What are the main findings of your study?

Dr. Osborn:  We found that knowing how to take your diabetes medications (e.g., what to do if a dose is missed), believing medications are good for you, and having the appropriate skills to take them regardless of the situation (e.g., when life is busy, when in public) accounts for 41% of why people successfully take their diabetes medications, which, in turn, explains 9% of their glycemic control.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Osborn: Other studies have found that enhancing patients’ medication adherence-related knowledge, motivation, and skills improves their medication adherence, but these studies have been largely with HIV patients whose main self-care task is taking medications. Our study brings that line of work into the diabetes space. Diabetes patients have a larger constellation of self-care requirements, including eating well, being active, and checking blood sugars. As a result, efforts to improve medication adherence has historically taken a backseat to helping patients eat better, be active, and monitor their blood sugars — even though medication adherence alone predicts glycemic control.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Osborn:  Unlike well-known barriers to medication adherence that are hard to address (e.g., cost, transportation to pharmacies), our study highlights intervenable factors that are addressable. Providers and diabetes educators should:

(1) Aim to improve patients’ knowledge of how and when to take their medications and what to do when a dose is missed,

(2) Explain to patients why their medications are beneficial and dispel myths that medications do more harm than good, and

(3) Help patients develop skills to be adherent regardless of the situation (e.g., plan ahead for schedule disruptions, trips and travel, and how to discretely take medications/insulin in public).

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Osborn:  Interventions aimed at improving adherence to diabetes medications should enhance patients adherence-related information, motivation, and behavioral skills, and test whether improvements in these mechanisms explain improvements in diabetes medication adherence, and, in turn, glycemic control.

Citation:

Empirical Validation of the Information–Motivation–Behavioral Skills Model of Diabetes Medication Adherence: A Framework for Intervention

Lindsay S. Mayberry andChandra Y. Osborn

Diabetes Care published ahead of print March 5, 2014, doi:10.2337/dc13-1828 1935-5548

 

 

No Comments

Sorry, the comment form is closed at this time.