The methodological quality and effectiveness of adherence interventions: a review of diabetes type II interventions (Artikel)

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The methodological quality and effectiveness of adherence interventions: a review of diabetes type II interventions (Artikel)
Autor Thomas Wilke, Sabrina Müller, Antje Groth
In: Value in Health
Ausgabe 13 (7)
ISBN/ISSN:
Erscheinungsjahr 2010
Jahrgang November 2010
Seitenzahl A295
Hyperlink
Review

OBJECTIVES: Adherence interventions (AI) are an important part of the health care provision situation on the ground. For ethical, clinical and health economic reasons, it is vital to identify methodological characteristics of successful AI. The aim of this review is to do this for AI focused on oral anti-diabetics (Diabetes type II). METHODS: A comprehensive review of Diabetes type II AI effectiveness studies was conducted [Strings: (oral hypoglycemic agents; oral anti-diabetic medications; diabetes; hyperglycemia; Biguanide; Metformin; Potassium channel inhibitors; Dipeptidyl peptidase-4 inhibitors) and (improvement; enhancement; pharmacy, pharmacist; doctors; interventions; programs; reminder; prevention; patient education)]. Only interventions aiming to improve medication adherence/persistence were included. RESULTS: A total of 6977 contributions were identifi ed; after detailed examination by two reviewers 15 publications evaluating 19 different AI were included. 10 AI were able to improve theadherence/persistence and eight were able to improve the blood glucose levels of patients (double counting in three cases); fi ve had no effect at all. Four dimensions of the methodological quality of AI programs were identifi ed: 1) measurement of adherence/ persistence/clinical outcomes, 2) measurement of NA/NP causes, 3) use of effective/ validated intervention measures; and 4) effective program evaluation. The authors defi ned 5 detailed methodological requirements per dimension and, based on this, developed a corresponding scoring model (MIN Score 0, MAX score 20). All 19 AI programs were evaluated in the scoring model (average score 8.05): • Score <5: 3 AI—no adherence/blood glucose level improvement; • Score 5–9: 8 AI—6 with improvement in both adherence and/or blood glucose levels; • Score >9: 8 AI—all improved adherence and/or blood glucose levels. CONCLUSIONS: The scoring model provides a starting point for the methodical evaluation of AI. However, further development and testing of both the elements and construction is needed for medical indications other than diabetes type II.