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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

Ting CY 1 , Ahmad Zaidi Adruce S 2 , Lim CJ 3 , Abd Jabar AHA 4 , Ting RS 5 , Ting H 6 Show all authors , Osman NA 7 , Ngau E 8 , Talin BA 9 , Muhammad M 10 , Loo SC 11 , Lim SE 12 , Hassali MA 13

Affiliations 

  • 1 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. Electronic address: tingchuoyew@gmail.com
  • 2 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. Electronic address: azshahren@unimas.my
  • 3 Clinical Research & Innovation Office, Tan Tock Seng Hospital, Singapore. Electronic address: limchienjoo90@gmail.com
  • 4 Pharmaceutical Services Division, Sarawak State Health Department Sarawak, Ministry of Health, Malaysia. Electronic address: abu.hassan@moh.gov.my
  • 5 Monash University, Jeffrey Cheah School of Medicine and Health Sciences, Selangor, Malaysia. Electronic address: ting.singkiat@monash.edu
  • 6 Sarawak Research Society, Sarawak, Malaysia; Faculty of Hospitality and Tourism Management, UCSI University, Malaysia. Electronic address: hiramparousia@gmail.com
  • 7 Pharmacy Practice and Development Division, Sarawak State Health Department Sarawak, Minitry of Health, Malaysia. Electronic address: noranizah@moh.gov.my
  • 8 Pharmacy Department, Petra Jaya Health Clinic, Petra Jaya, Kuching, Ministry of Health, Malaysia. Electronic address: esther_ngau@moh.gov.my
  • 9 Pharmacy Enforcement Division, Sarawak State Health Department Sarawak, Ministry of Health, Malaysia. Electronic address: benodict@moh.gov.my
  • 10 Pharmaceutical Services Division, Ministry of Health, Malaysia. Electronic address: munira_muhammad@moh.gov.my
  • 11 Pharmacy Enforcement Division, Sarawak State Health Department Sarawak, Ministry of Health, Malaysia. Electronic address: weekshing@gmail.com
  • 12 Pharmacy Practice and Development Division, Sarawak State Health Department Sarawak, Minitry of Health, Malaysia. Electronic address: limsuee@moh.gov.my
  • 13 Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia. Electronic address: azmihassali@gmail.com
Res Social Adm Pharm, 2021 02;17(2):344-355.
PMID: 32327398 DOI: 10.1016/j.sapharm.2020.03.026

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 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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