Abstract 17923: The Correlation of Patient Reported versus Observed Medication Adherence in Type 2 Diabetes (T2DM)

Introduction: Medication adherence in T2DM improves glycemic control (A1c) and is associated with reduced adverse clinical events. Self-reported medication adherence is a more feasible but less objective measure of actual adherence. Our aim was to determine the correlation between self-reported Morisky Medication Adherence Scale (MMAS) and direct observation of medication use by nurse practitioners (NP) during a home visit. Methods: In a cohort of high-risk patients (n=299) with T2DM in 4 counties participating in the Southeastern Diabetes Initiative (SEDI), we conducted a prospective intervention involving NP home visits. Baseline adherence was measured using self-reported MMAS and direct observation of pills, vials and pens. Adherence measures were dichotomized to “adherent” or “not adherent” using established cut-points. Interrater agreement was evaluated using Cohen’s Kappa. Results: In this cohort, the mean age was 58.6 (11.8), a majority were black (n=158, 52.8%), male (n=161, 53.8%), living with a partner (n=217, 76.4%) and insured by Medicare and/or Medicaid (n=248, 82.9%). Thirteen percent (n=30) had low health literacy ( Conclusions: Self reported medication adherence in high-risk patients with T2DM may be a poor indicator of actual medication use. Home visits may be needed in high-risk patients to more accurately assess medication use and decrease risks associated with medication dosing and administration errors.