An explanatory randomised controlled trial of a nurse-led, consultation-based intervention to support patients with adherence to taking glucose lowering medication for type 2 diabetes

Farmer, Andrew, Hardeman, Wendy ORCID: https://orcid.org/0000-0002-6498-9407, Hughes, Dyfrig, Prevost, A. Toby, Kim, Youngsuk, Craven, Anthea, Oke, Jason, Boase, Sue, Selwood, Mary, Kellar, Ian, Graffy, Jonathan, Griffin, Simon, Sutton, Stephen and Kinmonth, Ann Louise (2012) An explanatory randomised controlled trial of a nurse-led, consultation-based intervention to support patients with adherence to taking glucose lowering medication for type 2 diabetes. BMC Family Practice, 13. ISSN 1471-2296

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Abstract

Background: Failure to take medication reduces the effectiveness of treatment leading to increased morbidity and mortality. We evaluated the efficacy of a consultation-based intervention to support objectively-assessed adherence to oral glucose lowering medication (OGLM) compared to usual care among people with type 2 diabetes. Methods. This was a parallel group randomised trial in adult patients with type 2 diabetes and HbA1c7.5% (58 mmol/mol), prescribed at least one OGLM. Participants were allocated to a clinic nurse delivered, innovative consultation-based intervention to strengthen patient motivation to take OGLM regularly and support medicine taking through action-plans, or to usual care. The primary outcome was the percentage of days on which the prescribed dose of medication was taken, measured objectively over 12 weeks with an electronic medication-monitoring device (TrackCap, Aardex, Switzerland). The primary analysis was intention-to-treat. Results: 211 patients were randomised between July 1, 2006 and November 30, 2008 in 13 British general practices (primary care clinics). Primary outcome data were available for 194 participants (91.9%). Mean (sd) percentage of adherent days was 77.4% (26.3) in the intervention group and 69.0% (30.8) in standard care (mean difference between groups 8.4%, 95% confidence interval 0.2% to 16.7%, p=0.044). There was no significant adverse impact on functional status or treatment satisfaction. Conclusions: This well-specified, theory based intervention delivered in a single session of 30 min in primary care increased objectively measured medication adherence, with no adverse effect on treatment satisfaction. These findings justify a definitive trial of this approach to improving medication adherence over a longer period of time, with clinical and cost-effectiveness outcomes to inform clinical practice. Trial registration. Current Controlled Trials ISRCTN30522359.

Item Type: Article
Additional Information: This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://​creativecommons.​org/​licenses/​by/​2.​0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Uncontrolled Keywords: adherence,brief intervention,diabetes,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
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Depositing User: Pure Connector
Date Deposited: 19 Nov 2015 08:18
Last Modified: 30 Sep 2022 01:49
URI: https://ueaeprints.uea.ac.uk/id/eprint/55422
DOI: 10.1186/1471-2296-13-30

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