@article{3105798,
    title = "Influence of Supervised Disease Understanding and Diabetes Self-Management on Adherence to Oral Glucose-Lowering Treatment in Patients with Type 2 Diabetes",
    author = "Doupis, J. and Alexandrides, T. and Elisaf, M. and Melidonis, A. and Bousboulas, S. and Thanopoulou, A. and Pagkalos, E.M. and Avramidis, I. and Pappas, A. and Arvaniti, E. and Karamousouli, E. and Voss, B. and Tentolouris, N.",
    journal = "Diabetes Therapy",
    year = "2019",
    volume = "10",
    number = "4",
    pages = "1407-1422",
    publisher = "Springer Healthcare",
    issn = "1869-6953, 1869-6961",
    doi = "10.1007/s13300-019-0648-9",
    keywords = "hemoglobin A1c;  high density lipoprotein cholesterol;  low density lipoprotein cholesterol;  oral antidiabetic agent;  triacylglycerol, adult;  alcohol consumption;  Article;  assessment of humans;  clinical assessment;  comorbidity;  controlled study;  Diabetes Treatment Satisfaction Questionnaire;  diabetic nephropathy;  diabetic neuropathy;  diabetic retinopathy;  diastolic blood pressure;  dyslipidemia;  education program;  empowerment;  European Quality of Life 5 Dimensions questionnaire;  European Quality of Life 5 Dimensions Visual Analogue Scale;  female;  four item Morisky Medication Adherence Scale;  glucose blood level;  glycemic control;  health care quality;  heart infarction;  human;  hypertension;  ischemic heart disease;  male;  middle aged;  non insulin dependent diabetes mellitus;  patient compliance;  patient education;  patient satisfaction;  patient-reported outcome;  physical activity;  prevalence;  priority journal;  randomized controlled trial;  scoring system;  self care;  systolic blood pressure;  telephone interview",
    abstract = "Introduction: Systematic patient education has been reported to improve adherence to treatment, leading to better clinical outcomes. This cluster randomized real-world study investigated the effect of a systematic education program and telephone support on self-reported adherence to oral glucose-lowering treatment in patients with type 2 diabetes mellitus (T2DM). Methods: Centers were randomized (1:1) to provide either standard-of-care (control group) or standard-of-care along with the education program and telephone support (empowerment group). Adherence to treatment and satisfaction with treatment were assessed using the four-item Morisky Medication Adherence Scale (MMAS-4) and the Diabetes Treatment Satisfaction Questionnaire (DTSQ). The study population included 457 patients (258/199 male/female) with T2DM and non-optimal glycemic control, on oral antidiabetic treatment (age 62.7 [11.4]; disease duration 8.5 [6.5] years). Results: MMAS-4 high adherence rates for the control and empowerment groups were increased by 3.8% and 16.8% at 4 months (Breslow-Day test p = 0.04) and by 8.5% and 18.8% at 8 months of follow-up, respectively (Breslow-Day test p = 0.09), compared to baseline. Intense physical activity was increased in both control and empowerment groups by 2.3% and 13.9% at 4 months (Breslow-Day test p = 0.082) and by 4.0% and 22.5% at 8 months of follow-up (Breslow-Day test p < 0.001). Baseline mean (SD) HbA1c was significantly lower in the control group compared with the empowerment group [7.7% versus 8.0%, p = 0.001] and decreased in both groups at 4 months by 0.7% and 0.9%, respectively. The change from baseline in the mean DTSQ status score at 4 months was greater in the empowerment group, and the effect was sustained at 8 months (control group: 29.1, 30.5, and 30.9; empowerment group: 25.0, 28.7, and 29.4 at baseline, 4 and 8 months, respectively, p < 0.001). Conclusion: Systematic education combined with telephone support delivered by physicians might be associated with improvement in treatment adherence and treatment satisfaction in patients with T2DM. Funding: MSD, Greece. © 2019, The Author(s)."
}