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

• Published in: Patient preference and adherence Vol. 11; pp. 707 - 718
• Main Authors: Labrador Barba, Elena, Rodríguez de Miguel, Marta, Hernández-Mijares, Antonio, Alonso-Moreno, Francisco Javier, Orera Peña, Maria Luisa, Aceituno, Susana, Faus Dader, María José
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2017; Dove Medical Press
• Subjects: Activities of daily living; adherence; Analysis; Beliefs, opinions and attitudes; Diabetes mellitus; Diabetes therapy; Diabetics; Drug therapy; factors; Health aspects; Medical research; Original Research; Patient compliance; Patient monitoring equipment; persistence; Pharmacists; Physicians; Practice; Strategic planning (Business); strategies; Type 2 diabetes; Type 2 Diabetes Mellitus (T2DM); Spain; type 2 diabetes mellitus; persistence; strategies; adherence; factors
• ISSN: 1177-889X; 1177-889X
• DOI: 10.2147/ppa.s122556

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. 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. 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. 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.