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Ting CY, Ahmad Zaidi Adruce S, Lim CJ, Abd Jabar AHA, Ting RSK, Ting H, Osman NA, Ngau E, Talin BA, Muhammad M, Loo SC, Lim SE, Hassali MA. Effectiveness of a pharmacist-led structured group-based intervention in improving medication adherence and glycaemic control among type 2 diabetes mellitus patients: A randomized controlled trial. Res Social Adm Pharm 2020; 17:344-355. [PMID: 32327398 DOI: 10.1016/j.sapharm.2020.03.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND A pharmacist-led structured group-based intervention (MEDIHEALTH) was formulated to improve medication adherence among Malay type 2 diabetes mellitus (T2DM) patients in the Malaysian state of Sarawak. OBJECTIVES The objective of this study was to examine the effectiveness of MEDIHEALTH and its mechanism of impact for improving medication adherence and the glycated haemoglobin (HbA1c) level. METHODS A two group and parallel randomised controlled trial with a twelve months follow-up period was conducted at two primary health clinics in Malaysia that were surrounded by Malay communities. Malay T2DM patients whose HbA1c was >7% and total score on the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) was <26 were recruited and parallelly randomised to the MEDIHEALTH or usual care (control) groups. The extended theory of planned behaviour was employed to test the mechanism of impact. Repeated measure analysis of variance was used to assess the difference in the estimated marginal mean of the SEAMS scores and HbA1c level between the intervention and control groups at different times. RESULTS A total of 142 participants were recruited and randomised; three from the intervention group and eight from the control group withdrew before receiving any treatment. Hence, 68 participants in the intervention group and 63 in the control group were included for analyses. The MEDIHEALTH group had a significantly greater increase in the SEAMS score compared to the control group (p < 0.001) at one, three, six and twelve months post-intervention. There was also a significantly greater reduction in HbA1c in the MEDIHEALTH compared to the control group at one, three, six and twelve months post-intervention (p < 0.001). These improvements were mediated by enhancements in perceived behavioural control and knowledge about medications. CONCLUSIONS The MEDIHEALTH may improve medication adherence and glycaemic control among Malay T2DM patients.
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Affiliation(s)
- Chuo Yew Ting
- Institute of Borneo Studies, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia; Pharmacy Practice and Development Division, Sarawak State Health Department Sarawak, Minitry of Health, Malaysia.
| | - Shahren Ahmad Zaidi Adruce
- Institute of Borneo Studies, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia; Faculty of Cognitive Science and Human Development, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia.
| | - Chien Joo Lim
- Clinical Research & Innovation Office, Tan Tock Seng Hospital, Singapore.
| | | | - Rachel Sing-Kiat Ting
- Monash University, Jeffrey Cheah School of Medicine and Health Sciences, Selangor, Malaysia.
| | - Hiram Ting
- Sarawak Research Society, Sarawak, Malaysia; Faculty of Hospitality and Tourism Management, UCSI University, Malaysia.
| | - Nor Anizah Osman
- Pharmacy Practice and Development Division, Sarawak State Health Department Sarawak, Minitry of Health, Malaysia.
| | - Esther Ngau
- Pharmacy Department, Petra Jaya Health Clinic, Petra Jaya, Kuching, Ministry of Health, Malaysia.
| | - Benodict Apok Talin
- Pharmacy Enforcement Division, Sarawak State Health Department Sarawak, Ministry of Health, Malaysia.
| | - Munira Muhammad
- Pharmaceutical Services Division, Ministry of Health, Malaysia.
| | - Shing Chyi Loo
- Pharmacy Enforcement Division, Sarawak State Health Department Sarawak, Ministry of Health, Malaysia.
| | - Su Ee Lim
- Pharmacy Practice and Development Division, Sarawak State Health Department Sarawak, Minitry of Health, Malaysia.
| | - Mohamed Azmi Hassali
- Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
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