Background:
Medication adherence is an integral aspect of disease state management
for patients with chronic illnesses, including diabetes mellitus.
It has been hypothesized that patients with diabetes who have
poor medication adherence may have less knowledge of overall therapeutic
goals and may be less likely to attain these goals.
Objective: The purpose of this study was to assess self-reported
medication adherence, knowledge of therapeutic goals (hemoglobin
A1C [A1C], low density lipoprotein cholesterol [LDL-C] and blood
pressure [BP]), and goal attainment in adult patients with diabetes.
Methods: A survey was created to assess medication adherence,
knowledge of therapeutic goals, and goal attainment for adult
patients with diabetes followed at an internal medicine or a family
medicine clinic. Surveys were self-administered prior to office
visits. Additional data were collected from the electronic medical
record. Statistical analysis was performed.
Results: A total of 149 patients were enrolled. Knowledge of therapeutic
goals was reported by 14%, 34%, and 18% of survived patients for
LDL-C, BP, and A1C, respectively. Forty-six percent, 37%, and
40% of patients achieved LDL-C, BP, and A1C goals, respectively.
Low prescribing of cholesterol-lowering medications was an interesting
secondary finding; 36% of patients not at LDL-C goal had not been
prescribed a medication targeted to lower cholesterol. Forty-eight
percent of patients were medication non-adherent; most frequently
reported reasons for non-adherence were forgot (34%) and too expensive
(14%). Patients at A1C goal were more adherent than patients not
at goal (p=0.025).
Conclusion: The majority did not reach goals and were unknowledgeable
of goals; however, most were provided prescriptions to treat these
parameters. Goal parameters should be revisited often amongst
multidisciplinary team members with frequent and open communications.
Additionally, it is imperative that practitioners discuss the
importance of medication adherence with every patient at every
visit.
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