Article Text
Abstract
Background and importance Research has shown that patient centred interactions promote adherence and lead to improved health outcomes. The fundamental characteristics of patient centred care (PCC) were identified as (a) patient involvement in care and (b) the individualisation of patient care. The use of a numeric rating scale to measure the presence of these characteristics allows quantification from the patient perspective. Effective PCC practices were related to communication, shared decision making and patient education. The NICE guideline (CG76), the American Diabetic Association (2011) and the European Association for the Study of Diabetes (2015) recommended PCC to every person living with type 2 diabetes. However, there is a lack of empirical data for assessing the implementation of PCC and its relation to medication adherence in type 2 diabetic patients.
Aim and objectives The aim of the study was to assess and measure the implementation of PCC and its effect on medication adherence.
Material and methods We surveyed 224 type 2 diabetic patients attending our hospital diabetic clinic. We used the NICE self-reporting questionnaire to measure adherence and belief about medicine (BMQ), satisfaction with the information about medicines and illness perception to assess PCC. Univariate and multivariable logistic regression models were used to calculate the relation between adherence and PCC practice.
Results
Patients who were given adequate opportunity to be involved in decision making about their treatment were found to be more adherent with adjusted RR of 0.33 (95% CI 0.13 to 0.84, p=0.020).
Patients who have understanding about their illness and medicine were found to be more adherent with adjusted RR of 0.34 (95% CI 0.13 to 0.88, p=0.026).
Patients who are concerned about the side effects of diabetic medicines were found to be less adherent with RR of 1.17 (95% CI 0.45 to 3.02, p=0.038).
Conclusion and relevance Our survey results indicated that there was a statistically significant relation between PCC practice and medication adherence. We recommend PCC to be practised by doctors, pharmacists and diabetic specialist nurses to improve medication adherence in diabetic patients.
References and/or acknowledgements The NICE guideline (CG76), the American Diabetic Association (2011) and the European Association for the Study of Diabetes (2015).
Conflict of interest No conflict of interest