Medication therapy management (MTM): an innovative approach to improve medication adherence in diabetics

BACKGROUND: Medication therapy management (MTM) is a pharmacist-led professional service, one of the main aims of which is to improve patient medication adherence. Ensuring adequate adherence to the prescribed therapeutic regimen is one of the major challenges in attaining the desired therapeutic goals in diabetics. The objective of this study was to implement MTM in diabetic patients and to identify its effectiveness in improving patient medication adherence. METHODS: A prospective interventional study was carried out within a 1-year period in KIMS-Al-Shifa Hospital, which is a tertiary care referral hospital in Malabar region of Kerala, including inpatients with type 2 diabetes mellitus in the general medicine department of the hospital. The MTM programme was applied in selected patients, including personal medication record, medication-related action plan and detailed counselling. Adherence was measured using the Modified Morisky Medication Adherence Scale-4 both before and after the programme. RESULTS: A total of 104 patients were included in the study. The adherence of patients to anti-diabetic therapy was very low, which showed significant improvement after applying intervention (p-value<0.05 in a paired t-test). Initially, only 37.5% had high adherence which was increased to 59.5% after intervention. Age and educational status were identified to have a significant impact on patient medication adherence (p-value<0.05 in a χ2-test). CONCLUSIONS: Medication adherence is a key component of self-management for patients with diabetes. A pharmacist-led MTM programme if appropriately designed and implemented will have a potential positive impact on medication adherence in diabetic patients.