Medication adherence and persistence in type 2 diabetes mellitus: perspectives of patients, physicians and pharmacists on the Spanish health care system.

Autor: Labrador Barba E; Department of Medicine, Mylan, Madrid., Rodríguez de Miguel M; Department of Medicine, Mylan, Madrid., Hernández-Mijares A; Department of Endocrinology and Nutrition, Doctor Peset University Hospital, Valencia.; Department of Medicine, University of Valencia, Valencia., Alonso-Moreno FJ; Department for Primary Health Care, Centro de Salud Sillería, Toledo., Orera Peña ML; Department of Medicine, Mylan, Madrid., Aceituno S; Outcomes'10, Castellon., Faus Dader MJ; Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, University of Granada, Granada, Spain.
Jazyk: angličtina
Zdroj: Patient preference and adherence [Patient Prefer Adherence] 2017 Apr 04; Vol. 11, pp. 707-718. Date of Electronic Publication: 2017 Apr 04 (Print Publication: 2017).
DOI: 10.2147/PPA.S122556
Abstrakt: Objective: A good relationship between diabetes patients and their health care team is crucial to ensure patients' medication adherence and self-management. To this end, we aimed to identify and compare the views of type 2 diabetes mellitus (T2DM) patients, physicians and pharmacists concerning the factors and strategies that may be associated with, or could improve, medication adherence and persistence.
Methods: An observational, cross-sectional study was conducted using an electronic self-administered questionnaire comprising 11 questions (5-point Likert scale) concerning factors and strategies related to medication adherence. The survey was designed for T2DM patients and Spanish National Health System professionals.
Results: A total of 963 T2DM patients, 998 physicians and 419 pharmacists participated in the study. Overall, a lower proportion of pharmacists considered the proposed factors associated with medication adherence important as compared to patients and physicians. It should be noted that a higher percentage of physicians in comparison to pharmacists perceived that "complexity of medication" (97% vs 76.6%, respectively) and "adverse events" (97.5% vs 72.2%, respectively) were important medication-related factors affecting adherence. In addition, both patients (80.8%) and physicians (80.8%) agreed on the importance of "cost and co-payment" for adherence, whereas only 48.6% of pharmacists considered this factor important. It is also noteworthy that nearly half of patients (43%) agreed that "to adjust medication to activities of daily living" was the best strategy to reduce therapeutic complexity, whereas physicians believed that "reducing the frequency of administration" (47.9%) followed by "reducing the number of tablets" (28.5%) was the most effective strategy to improve patients' adherence.
Conclusion: Our results highlight the need for pharmacists to build a stronger relationship with physicians in order to improve patients monitoring and adherence rates. Additionally, these findings may help to incorporate greater patient-centeredness when developing management strategies, focusing on adjusting medication regimens to patients' daily lives.
Competing Interests: Disclosure The authors report no conflicts of interest in this work.
Databáze: MEDLINE
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