OBJECTIVES: To examine the relationship between Hemoglobin A1c (HbA1c) values and medication adherence over time in diabetic patients participating in a pharmacist-conducted Medication Therapy Management program (MTMP). METHODS: This study used a prospective, intention-to-treat, pre-post longitudinal design assessing the impact of a pharmacist-conducted employer sponsored MTMP on clinical and humanistic outcomes of employees, their spouses and covered dependents with Type 2 diabetes. Enrollment began in January 2008. As an incentive to participate, patients received a 3 month supply of medications at the cost of one copay. Pharmacist interventions included medication therapy reviews, discussing details about patients' disease state and the importance of medication adherence, and informing patients about appropriate lifestyle modifications. HbA1c was measured using the Cholestech LDX at the pharmacy every three months and adherence was measured at baseline, 3 months, and nine months. Patient reported adherence was measured using the Morisky scale. Currently, most patients have completed six months in the program therefore analysis focused on comparing baseline and the three month time point. A Wilcoxon signed-rank test was used to determine changes in HbA1c values over time and a Spearman correlation was used to examine any relationship. RESULTS: Patients who began the program with uncontrolled HbA1c values experienced a significant decrease of 0.79% in HbA1c values from baseline to 3 months. Adherence levels improved significantly from baseline to 3 months (p < 0.05). There was a significant inverse relationship between A1c levels and medication adherence at 3 months (Spearman's r=-0.264, a= 0.05, N = 70). Final results will be presented at the conference. CONCLUSIONS: As adherence to medications increased there was a decrease in HbA1c values. Patients with improved adherence were able to maintain better glycemic control. To further improve outcomes for employees with diabetes and improve long-term cost-savings, employers might need to focus on programs that target medication adherence.
Pinto, S., & Holl, S. (2009). PDB44 EXAMINING THE RELATIONSHIP BETWEEN GLYCEMIC CONTROL AND MEDICATION ADHERENCE IN DIABETIC PATIENTS. Value in Health, 12(7), A409–A410. https://doi.org/10.1016/s1098-3015(10)75022-1