Increasing Patient Knowledge Can Improve Diabetes Medication Adherence

Adherence to diabetes medication among adults with type 2 diabetes mellitus (T2DM) could be improved with increased patient knowledge, according to research published in Diabetes Care.

Researchers from Vanderbilt University surveyed 314 low-income, diverse adults with T2DM to test the Information-Motivation-Behavior Skills (IMB) adherence model, which included questions on adherence-related information, motivation, behavior skills on medication compliance, and the effects of medication adherence on hemoglobin A1C (HbA1C). The researchers noted in other contexts, the IMB model effectively explained and promoted medication compliance and may additionally be useful in promoting adherence to diabetes medications.

The researchers found IMB elements explained 41% of the variance in adherence, while adherence explained 9% of the variance in HbA1C. The scientists also correctly predicted that behavioral skills had a direct effect on compliance, which influenced information and motivation. Adherence also predicted glycemic control, though neither insulin status nor regimen complexity was associated with adherence.

“Medication adherence promotion interventions may benefit from content targeting patients’ medication adherence-related information, motivation, and behavioral skills, (as well as) assessing the degree to which change in these determinants leads to changes in medication adherence behavior,” the authors wrote.

The researchers noted the patients’ reasons for not taking their medications, which included believing medications don’t keep diabetes in control, fear of side effects like weight gain, poor planning to maintain medication adherence during trips, and being in public.

“A lot of our attention has been focused on how do we promote physical activity and good nutrition for these patients, and so this paper is really all about putting the focus on medication adherence and how do we start doing that better,” Chandra Osborn, PhD, MPH, leader of the study, said in a statement. “There needs to be conversations between providers and patients on what to do when doses are missed. There also needs to be a way of understanding what these beliefs are that patients have around the fear associated with taking insulin and the belief that if they take certain medications they are going to gain weight.”

Study co-author Lindsay Satterwhite Mayberry, PhD, MS, continued in the statement, “we found that adherence was related to knowing how and when to take a medication and how to handle a missed dose.” Mayberry speculated a lot of patients may believe that if they miss a dose, they are unsure if they should double it the next time or skip it entirely; however, any missed doses should be discussed with a qualified healthcare provider on a case-by-case basis, she said.