Study questions role of allied health in medicine adherence

THERE is little evidence to support the assumption that interventions by allied health professionals can help improve patients’ medication adherence, a new literature review has revealed.

Published in Diabetic Medicine, the review analysed data drawn from studies into using allied health professionals – including nurses, pharmacists and diabetes educators – to improve medication adherence in patients with type 2 diabetes. 

Interventions included telephone interviews, short messaging services (SMS), and counselling. 

Review author Dr Sheila Doggrell (PhD), senior lecturer in medical sciences at the Queensland University of Technology, said there was limited evidence to suggest such interventions were successful. 

“We just assume that if you send someone off to a diabetic educator they are going to be better off,” she said. “But there isn’t that much evidence that this is true.”

Dr Doggrell noted that while the quality of the studies reviewed was at times problematic, the review showed that counselling by pharmacists had no effect on medication adherence by patients with poor compliance. Similarly, there was no strong evidence that counselling by a nurse or diabetes educator improved medication adherence. “We do not know which is the best intervention and whether it is best delivered by a nurse, pharmacist or diabetes educator,” Dr Doggrell said.   

The review also found studies had not specifically targeted patients with low adherence to diabetes medication, but rather included patients with already high levels of adherence. 

“We need to start off by...actually selecting out the people that don’t take their medication and then perhaps putting in a more intense intervention,” she said. 

Diabetic Medicine, in press