Improving Medication Adherence in Patients with Type 2 Diabetes Mellitus through Home Visits by Pharmacists in Sri Sut Tho Primary Care Unit at Bandung Crown Prince Hospital

Abstract

Objective: To study the improving of medication adherence (MA) in type 2 diabetic patients through home visits by pharmacists of Sri Sut Tho primary care unit, Bandung Crown Prince Hospital. Method: This research was a quasi-experimental study. The subjects consisted of 40 type 2 diabetic patients who used at least one oral diabetic medication and had a blood sugar level (HbA1C) more than 8%. The home visits by pharmacists consisted of 4 phases. Phase 1 was the data collection of blood sugar levels (fasting blood sugar: FBS), HbA1C, MA assessed by the Medication Adherence Scale for Thais (MAST), and pill counting, and knowledge on diabetes medications. This phase was carried out during weeks 1-4 of the study, Phase 2 was the development of home visiting activities during weeks 5-6. Phase 3 involved conducting at least one home visit for each patient within weeks 7-12. Phase 4 was the assessment of study outcomes including FBS, HbA1C, MA assessed by the MAST scale and pill count, and knowledge on diabetes medications after home visit. Results: Patients had a statistically significant increase in MA. The median MAST score significantly increased from 32 to 37 (total score of 40) (P<0.001). Median MA rate assessed by pill count significantly increased from 78.62% to 95.57% (P<0.001). The mean knowledge on diabetes medications significantly increased from 7.15±1.61 to 9.28±0.93 (total score of 10) (P<0.001). The median FBS decreased significantly from 172.50 mg/dl to 129.00 mg/dl (P<0.001) and the mean HbA1C decreased from 10.14±1.79 to 8.34±1.23 %(P<0.001). Conclusion: Home visits by pharmacist improved MA, knowledge on diabetes medications, and glycemic control of patients. Therefore, home visit should be applied to patients with other diseases who have problems with MA and disease control.