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Interventie op maat bij therapie-ontrouwe diabetespatiënten: kwalitatief onderzoek naar de uitvoerbaarheid van de interventie.

Adhien, P., Dijk, L. van, Vegter, M., Westein, M., Nijpels, G., Hugtenburg, J.G. Interventie op maat bij therapie-ontrouwe diabetespatiënten: kwalitatief onderzoek naar de uitvoerbaarheid van de interventie. Pharmaceutisch Weekblad Wetenschappelijk Platform: 2012, 6(1), a1204
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Objective: To examine the feasibility of an intervention to improve therapy adherence. Such interventions are often ineffective, possibly because they are not tailored to the patient. We developed a modular intervention which pharmacists can use to improve drug therapy adherence. Patients’ experiences with the intervention were also studied. Design: Focus group interviews with pharmacists and pharmacy technicians and questionnaire interviews among diabetes patients. Methods: Four pharmacy teams in the Rotterdam region were trained in therapy adherence and motivational conversation techniques. Patients with diabetes mellitus type 2, who were not adherent with drug use, were asked to participate. The intervention consisted of a structured interview, an intervention guide and modular interventions tailored to the causes of non-adherence. The interview asked patients for problems with the drug therapy. The intervention modules addressed five common causes of non-adherence: ineffectiveness, side effects, problems with swallowing, forgetting drug taking and motivation. The feasibility of the intervention was discussed in a focus group interview with the pharmacy teams. Patients’ experiences (n = 36) were measured by means of a questionnaire. Results: Pharmacy teams appreciated the intervention, the materials and the involvement of pharmacy technicians. Poor co-operation with the general practitioner, lack of time and lack of financial compensation appeared to be interfering factors. Patients appreciated the intervention and they indicated to be well able to follow the advice of the pharmacists. Conclusion: The intervention is well feasible and patients appreciated the intervention. Poor co-operation between pharmacists and general practitioners, and lack of reimbursement hamper the implementation at a large scale. (aut. ref.)