Empowered patients more likely to stick to diabetes treatments

Individuals with greater diabetes empowerment are more adherent to their medication treatment plans, while those with lower diabetes empowerment are less adherent, according to a study published in Diabetes Technology and Therapeutics.

In addition, those with greater diabetes empowerment have greater knowledge about diabetes, have healthier diets, are more physically active, and test their blood sugar more frequently compared to individuals with lower diabetes empowerment, according to one of the study’s authors, Leonard E. Egede MD, MS, Allen H. Johnson Endowed Chair, professor of medicine and director, Center for Health Disparities Research, Medical University of South Carolina in Charleston.

Egede

“This study demonstrates how empowerment in diabetes management may serve as a key factor that enables patients to take greater control and responsibility for their self-management,” Egede told FormularyWatch. “Integration of methods to increase empowerment into diabetes treatment plans may serve to effectively bridge the gap that exists between clinical recommendations and patients’ perceptions and goals. By emphasizing patient empowerment in prescribing guidelines and clinical information, formulary managers may foster optimal outcomes and adherence to treatment plans by way of empowering patients.”   

The study, “Diabetes Empowerment, Medication Adherence and Self-Care Behaviors in Adults with Type 2 Diabetes,” evaluated 378 patients with type 2 diabetes recruited from 2 primary care clinics in the southeastern United States between June 2010 and August 2010. Once subjects were recruited, the researchers used previously validated scales to measure diabetes empowerment, medication adherence, diabetes knowledge, and diabetes self-care behaviors (including diet, physical activity, blood sugar testing, and foot care).

This study used multiple linear regression to determine the relationship between diabetes empowerment and medication adherence and self-care behaviors.

“After initially testing correlations between the variables, we used multiple linear regression to determine independent associations between diabetes empowerment, and medication adherence and self-care behaviors, controlling for relevant covariates such as age, race, gender, education, and income,” Egede said.

“In patients with diabetes, empowerment is an important factor toward achieving better outcomes through medication adherence,” he continued. “In particular, integration of empowerment into diabetes management plans may help improve self-efficacy in the patient and increase the sense of partnership with providers in diabetes care, ultimately resulting in better health outcomes.”

Formulary managers have a unique ability to facilitate care and improve outcomes in patients with diabetes by increasing recognition of the influence of empowerment on important behaviors, such as medication adherence, according to Egede.

“This can be done through information and guidance that could be included in patient and provider educational materials,” he said.

Diabetes outcomes are greatly influenced by a patient’s effectiveness in self-management and lifestyle behaviors, according to Egede. “This includes the ability to adhere to medication treatment plans, and maintain diet and exercise regimes,” he said. “While many barriers to adherence exist, by increasing empowerment one promotes the ability for a patient to comply with medication treatment plans, self-care behaviors, and ultimately achieve optimal outcomes and lower disease-related medical costs.”