Diabetes Studies / Medication Compliance / Patient AdherenceThe least compliant diabetes patients were more than twice as likely to be hospitalized compared to those who were most compliant, and their total health-care costs were nearly double. The study notes that people who use their diabetes medications as directed are less likely to develop the short-term and long-term health problems that can require expensive care. For diabetes, every additional dollar spent on medication saved $7 in medical costs. The combined drug and medical costs for the most-compliant diabetes patients average $4,570, which is almost 50 percent below the $8,867 cost for the least-compliant group. Human Resource Executive, May 2, 2006 Tom Starner From the Medco Study on Diabetic Non-Compliance, 2005, Dr. Robert Epstein Link Nearly two-thirds (64%) of 2,507 US adults report that they have simply forgotten to take their medication, with 11 percent saying that this has happened "often" or "very often." Harris Interactive/The Wall Street Journal March 29, 2005 Online Survey Link The web-based intervention using SMS messaging improved levels of HbA1c and 2HPMG in type-2 diabetic patients for the six-month duration of the trial. Journal of Clinical Nursing, June, 2007, Vol. 16 No. 6, pp 1082-1087 Hee-Seung Kim, Ph.D., RN; Hye-Sun Jeong PhD, RN Control group pre-test-post-test design Link This study was designed to assess the persistence of outcomes for up to 5 years following the initiation of the The Asheville Project, a program of community-based pharmaceutical care services (PCS) for patients with diabetes. Mean A1c decreased at all follow-ups, with more than 50% of patients demonstrating improvements at each time. The number of patients with optimal A1c values (< 7%) also increased at each follow-up. More than 50% showed improvements in lipid levels at every measurement. Costs shifted from inpatient and outpatient physician services to prescriptions, which increased significantly at every follow-up. Total mean direct medical costs decreased by $1,200 to $1,872 per patient per year compared with baseline. Patients with diabetes who received ongoing PCS maintained improvement in A1c over time, and employers experienced a decline in mean total direct medical costs. Journal of the American Pharmaceutical Association 2003 Mar-Apr;43(2):173-84 Barry A. Bunting and Carole W. Cranor, DB Christensen ( Comparative Study) Link |
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Schizophrenia Medication Compliance Patient AdherenceThe results of this study clearly demonstrate that in an outpatient mental health clinic, computer reminders were shown to be superior to manual reminders in improving adherence to a clinical practice guideline for depression JAMIA, 2000;7:196–203 Dale S. Cannon and Steven N. Allen Independent, randomized controlled study: http://www.jamia.org/cgi/content/abstract/7/2/196 The therapeutic relationship that a clinician builds with his or her patient is a cornerstone of treatment compliance. The most important factor influencing compliance was the patient’s perception of the doctor’s interest in him or her, which is clearly reinforced by the amount of time that physicians spend with their patients. Such a relationship is a prerequisite for a working therapeutic alliance, and providing reliable information is a crucial factor in this context. Information can be given to patients and their relatives or significant others, either informally during scheduled visits or in psychoeducational groups. Providing information includes discussing treatment plans regularly with patients and their significant others, which gives both an active part in the treatment planning process. J Clin Psychiatry 2003;64[suppl 16]:10–13) W. Wolfgang Fleischhacker; Maria A. Oehl; and Martina Hummer http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView& TermToSearch =14680413&ordinalpos=1&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum |

