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Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitusVermeire EIJJ, Wens J, Van Royen P, Biot Y, Hearnshaw H, Lindenmeyer A
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SummaryInterventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitusTwenty-one studies assessing interventions to improve adherence to treatment recommendations, not to diet or exercise, in people with type 2 diabetes in different settings (outpatients, community, hospitals, primary care) were included. There were many outcomes evaluated in these studies and a variety of adherence measurement instruments was used. Nurse led interventions, home aids, diabetes education and pharmacy led interventions showed a very small effect on some outcomes including metabolic control. No data on mortality or morbidity, nor on quality of life could be found.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 4, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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April 20. 2005 AbstractBackgroundResearch suggests adherence to treatment recommendations is low. In type 2 diabetes, which is a chronic condition slowly leading to serious vascular, nephrologic, neurologic and ophthalmological complications, it can be assumed that enhancing adherence to treatment recommendations may lead to a reduction of complications. Treatment regimens in type 2 diabetes are complicated, encompassing life-style adaptations and medication intake. ObjectivesTo assess the effects of interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus. Search strategyStudies were obtained from searches of multiple electronic bibliographic databases supplemented with hand searches of references. Selection criteriaRandomised controlled and controlled clinical trials, before-after studies and epidemiological studies, assessing changes in adherence to treatment recommendations, as defined in the objectives section, were included. Data collection and analysisTwo teams of reviewers independently assessed the trials identified for inclusion. Three teams of two reviewers assessed trial quality and extracted data. The analysis for the narrative part was performed by one reviewer (EV), the meta-analysis by two reviewers (EV, JW). Main resultsTwenty-one studies assessing interventions aiming at improving adherence to treatment recommendations, not to diet or exercise recommendations, in people living with type 2 diabetes in primary care, outpatient settings, community and hospital settings, were included. Outcomes evaluated in these studies were heterogeneous, there was a variety of adherence measurement instruments. Nurse led interventions, home aids, diabetes education, pharmacy led interventions, adaptation of dosing and frequency of medication taking showed a small effect on a variety of outcomes including HbA1c. No data on mortality and morbidity, nor on quality of life could be found. Authors' conclusionsCurrent efforts to improve or to facilitate adherence of people with type 2 diabetes to treatment recommendations do not show significant effects nor harms. The question whether any intervention enhances adherence to treatment recommendations in type 2 diabetes effectively, thus still remains unanswered. |