Bridging the Adherence Gap: Innovative Counseling Strategies and their Effect on HbA1c in Type 2 Diabetes Patients

Abstract

Background: Medication adherence is essential for effective Type 2 Diabetes Mellitus (T2DM) management; still, non-adherence occurs in countries with low or middle incomes like India, leading to uncontrolled glycemia and comorbidities. The study objectives were to assess adherence patterns in T2DM patients, identify non-adherence factors, evaluate the effectiveness of awareness measures, and follow HbA1c changes to establish adherence-related outcomes.Materials and Methods: The 12-month prospective observational study was conducted in the General Medicine and Endocrinology outpatient departments of a tertiary care hospital. It utilized the 8-item Morisky Medication Adherence Scale (MMAS-8) and 15-item Medication Adherence Reasons Scale (MARS-15) to measure adherence and identify non-adherence factors. The study also offered patient verbal counseling and follow-ups to assess effectiveness.Results: The study found that glycemic control improved, with HbA1c levels dropping from 61.49% to 52.17% and medication adherence dropping from 55.9% to 23.6%. Factors contributing to poor adherence included forgetfulness 89 (20.36%), medication cost 36 (8.23%), and concerns about side effects 39 (8.92%).Conclusion: Verbal counseling and leaflets significantly improved medication adherence and glycemic control in T2DM patients by overcoming barriers like forgetfulness, inconvenience in taking medications as prescribed, and fear of side effects, emphasizing the importance of patient-centered education strategies.

Keywords: Counseling; HbA1c; Medication Adherence; Medication Adherence Reasons Scale (MARS-15); Morisky Medication Adherence Scale (MMAS-8); Type 2 Diabetes mellitus (T2DM)