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10/30/2014

Chronic Medication Adherence: Diabetes

Diabetes is a chronic disease that affects millions of Americans. It is a group of metabolic disorder characterized by persistent hyperglycemia. Early diagnosis and proper treatment is important to reduce complications such as coronary artery disease, blindness, and loss of sensation. However, as stated by Dr. C. Everett Koop “Drugs don’t work in patients who don’t take them.”

Diabetes is one the leading causes of death. It is very important to eat a healthy diet especially with this disease. Patients who have diabetes should be encouraged to modify their diet to include more vegetables, whole grains, fruits, non-fat dairy products, beans, lean meats, poultry, and fish. A study done to see the correlation of self-monitoring of blood glucose to weight loss by doing a weight loss intervention showed increased self-monitoring of blood glucose and greater weight loss was achieved through better adherence to diet. The authors concluded self-monitoring of blood glucose leads to increased adherence to diet. Also, patients that were educated about the impact of diet on weight loss, showed increase adherence to diet and better glucose control.

A retrospective literature search was conducted by Cramer to assess the adherence to oral hypoglycemic agents and insulin products and its effect on glycemic control in diabetes patients. In this systematic analysis, she found that electronic monitoring was effective in identifying patients who were poorly adherent.   The study showed that electronic monitoring systems can be used to increase adherence by providing health care providers the information needed to identify patients than need interventions.

Pharmacists today use electronic monitoring through computerized programs that measure adherence rates such as refill rates. There are many ways pharmacists can intervene to increase adherence rates with chronic medications, such as oral hypoglycemic medications. Non-adherence can be detrimental to patients, so pharmacists can intervene by counseling newly diagnosed individuals of the benefits of taking their medication properly and the risks that may occur if medication is not taken. Also, pharmacists can review adherence rates with patients to identify reasons why patients may not be taking their medications. If patients cannot tolerate certain medications, or cannot follow directions appropriately, pharmacists can suggest other products.

The cost of not taking medications is high in patients with chronic medications, so it is important that pharmacists and patients work together to create a regimen that is most beneficial.

 

Urvi Patel, PharmD’16

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