Diabetes Clinical Trial
Official title:
The Medication Adherence Program:Promoting Diabetes Self-Management Through Community Pharmacies
In this study, the investigators will evaluate the impact of a Medication Adherence Program (MAP), a systematic telephone call to patients who are overdue for refills, to assess individual reasons or barriers to refilling prescribed DM medicines, discuss diabetes care progress, and provide intervention to resolve any barriers to taking prescribed medicines. The hypothesis for the study is that personalized telephone follow-up by a pharmacist will assist people who have missed refilling their prescriptions in taking diabetes medicines by resolving medication adherence challenges. Following randomization, the intervention will be offered to patients of four Seattle-area Safeway Pharmacies, Inc, who are overdue for prescribed DM medicine refills by at least 6 days. Control subjects will receive usual pharmacy care at the participating Safeway pharmacies as a comparison. The study will provide medication adherence support to intervention subjects for 12 months following enrollment with the goal of improving medication refilling and persistence.
Taking medicines can be a challenge for those with diabetes mellitus (DM) with adherence
rates to DM medicines as low as 31%. Adherence to DM medicines improves DM by reducing blood
glucose (ie A1c reduction) but will also result in improved outcomes, reduced cardiovascular
risks, and reduced costs of diabetes. The most common factors reported to affect medication
taking in those with DM include difficulty remembering refills and doses, regimen complexity
(e.g more than one DM drug, need to split tablets, mix products), dosing frequency greater
than twice daily, depression, and adverse effects or fear of them.
Pharmacists have immense opportunity to interact with people with DM, who now number over 20
million in the United States (US). This reality is due to several factors including
convenience of pharmacies (found in most urban, suburban, and rural communities),
accessibility of pharmacists for questions and counseling (appointments not usually
required), and strong rapport that pharmacists and their staff develop with long-term
patients and their families through their presence in the community. Pharmacists in
community practices work directly with patients and review refill information about patient
medication use thus allowing for personalized, immediate, and ongoing promotion of
adherence. Currently, pharmacists do not routinely call patients who are overdue for
prescription refills to ascertain if the refill is still needed or proactively work to
resolve any barriers to refilling. The standard of care is to provide refill and medication
adherence support if it is requested by a patient and if the pharmacy is able to provide the
needed level of support.
In this study, we will evaluate the impact of a Medication Adherence Program (MAP), a
systematic telephone call by a pharmacist to patients who are overdue for refills, to assess
individual reasons or barriers to refilling prescribed DM medicines and provide intervention
to resolve any barriers.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Caregiver), Primary Purpose: Health Services Research
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