Does Improving Adherence Benefit Outcomes in Diabetes?

Methods like electronic health records can significantly improve treatment adherence among patients with type 2 diabetes, but that adherence does not translate to improvements in clinical outcomes, according to a recent study.

Adherence rates among patients with diabetes tend to be poor, but the reasons behind this trend are not well understood.
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In order to test whether improving adherence would improve clinical outcomes, researchers conducted a study of 96 patients with type 2 diabetes with at least 1 active diabetes prescription. In their study, researchers entered patient data, including HbA1c and cholesterol levels, into a “clinical dashboard” within an electronic health record system. Of the 96 participants, 24 logged into the patient portal to report on barriers to adherence.

Overall, adherence improved significantly among all patients. However, clinical outcomes, including HbA1c, blood pressure, cholesterol, and visits to the emergency room remained greatly unchanged.

“Although the primary objective was achieved, we did not observe any meaningful changes to patients’ health status,” they concluded.

They cited the length of the 9-month pilot as a potential reason for a lack of improvement in clinical outcomes.

“The results from our early pilot of an integrated approach are promising. Yet, they suggest additional research and development to better design, implement, and integrate the myriad of electronic health record and clinical decision support systems, as well as patient devices, into routine care and patient processes that together support health and well-being.”

—Michael Potts

Reference:
Dixon BE, Alzeer AH, Phillips EO, Marrero DG. Integration of Provider, pharmacy, and patient-reported data to improve medication adherence for type 2 diabetes: a controlled before-after pilot study. JMIR Med Inform 2016;4(1):e4.