Effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with Type 2 diabetes.

Abstract

This review aims to answer the following question: What is the effect of educational interventions in promoting oral hypoglycaemic adherence in adults with Type 2 diabetes? The objectives of this review are to: •Determine whether educational interventions implemented had any effect inpromoting oral hypoglycaemic adherence. • Suggest contributing factors of educational interventions that were able to promote oral hypoglycaemic adherence or otherwise. Participants: The review will consider all studies that include adults over 18 years old with Type 2 diabetes, with or without co-morbidities, currently taking oral hypoglycaemic medication, and with HbA1c > 7.0% prior to the intervention. Participants can be found in the primary, tertiary or acute care setting. Interventions: Included studies should discuss educational interventions that measured participants’oral hypoglycaemic medication adherence as an outcome. Ellis et al. (2004, p. 98) defined an educational intervention as “any non-pharmacological educational technique that used physical, intellectual, or psychosocial means to improve the health of patients with diabetes.” Techniques may include didactic or enhanced learning methods to increase knowledge, goal setting (dictated or negotiated), situational problem solving, or cognitive reframing. Therefore, the definition of an educational intervention in the current review is any non-pharmacological educational technique, in the form of didactic teaching, goal setting, situational problem solving, cognitive reframing, or other methods that use physical, intellectual, or psychosocial means to improve diabetes self-management by increasing knowledge. The intervention may cover all forms of education offered by health professionals, including but not limited to, face-to-face education, individual or group education, telephone interventions, diabetes education programmes, and health promotion literature. Outcome measures: The primary outcomes of interest include any measure defined by included studies such as: • glycated haemoglobin (HbA1c) concentrations • self-reported medication adherence questionnaire scores • self-recorded blood glucose logs • tablet count • electronic monitoring of every opening (date and time) of medication containers • other measures that reflect medication adherence or compliance, such as diabetes complications and health service utilisation These outcomes should be measured at baseline prior to the intervention and measured again during follow-up. Studies which did not state explicitly the method used to determine medication adherence, or measured adherence with diet or exercise but not medication, will be excluded.