Examining the Association between Treatment Satisfaction and Medication Adherence among Patients with Poorly Controlled Type 2 Diabetes

Abstract

Adherence to diabetes medications remains an important target for public health intervention, however, approximately 32% of people living with diabetes do not take their medications as they should. We examined the association between treatment satisfaction and medication adherence in people living with type 2 diabetes from the REdesigning MEDication Intensification Effectiveness Study for Diabetes (REMEDIES 4D) study. REMEDIES 4D was a clustered, randomized trial in which certified diabetes educators (CDEs) implemented standardized treatment protocols to intensify treatment for glucose, lipid or blood pressure control. Fifteen practices and their patients were randomized to the intervention or usual care. Eligible participants had uncontrolled HbA1c, blood pressure, or LDLc. The intervention group received diabetes self-management education in addition to treatment intensification, while the usual care group participated in monthly support groups for one year. Medication adherence and treatment satisfaction scores were measured using Morisky medication adherence scale and Medication satisfaction survey respectively. A mixed model was created to account for the cluster randomized design and included covariates for treatment status (intervention vs. usual care group), sociodemographic factors, depression, insulin use, count of comorbidities, polypharmacy, baseline clinical values, adherence score at baseline and treatment satisfaction scores 12 months post-baseline. There were 135 participants in the final study population (mean age of 60 years and 51% female). After controlling for covariates, treatment satisfaction was associated with an increase in adherence to diabetes medications (β=0.34, p=0.02). Ensuring patients with type 2 diabetes are satisfied with their treatment regimen may be a crucial step to improving adherence to diabetes medications. Disclosure N. Emechebe: None. N. Agu: None. M. Malmi: None. J.C. Zgibor: None.