An education intervention for medication adherence in uncontrolled diabetes in Thailand

Abstract

Medication adherence is crucial to achieving diabetic control. This quasi-experimental two-group pre-/post-test design aimed to evaluate the effects of a medication education intervention integrated in routine services of a diabetes clinic. People with uncontrolled type 2 diabetes treated by oral medication and history of non-adherence to medication were assigned to an intervention group (n=39) and a comparison group (n=37). The intervention group received medication education intervention four times consisting of a short individual education session provided by the physician and group counseling session provided by a nurse in a diabetes clinic at weeks 1 and 3, then individual follow-up telephone counseling by a nurse at weeks 6 and 9. The comparison group received patient education as routine service. Outcome variables including knowledge of medication use, beliefs and adherence, and blood glucose level were assessed at weeks 1 and 12, using an interview questionnaire and laboratory test of HbA1c values. The results showed the intervention group had significantly better mean changes of knowledge of medication use, medication beliefs and medication adherence, than the comparison group. In addition, HbA1c in the intervention group decreased more significantly than the comparison group. The findings imply a success of the integrated medication education intervention. Nurses within healthcare teams can initiate this education intervention in routine services of diabetes clinics. However, further testing of the intervention with other populations is required to substantiate its effects.