Lazy Sunday afternoons

the negative impact of interruptions in patients’ daily routine on adherence to oral antidiabetic medication. A multilevel analysis of electronic monitoring data

M. Vervloet, P. Spreeuwenberg, M. Bouvy, E.R. Heerdink, D.H. de Bakker, L. van Dijk

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Purpose
Considerable variability in adherence over time exists. The aim of this study was to investigate to what extent deviations from the prescribed regimen in type 2 diabetes patients can be explained by characteristics of the individual ‘medication intake moments’ and the patient.
Methods
Medication intake of 104 non-adherent type 2 diabetes patients from 37 community pharmacies was electronically monitored for 6 months. The primary outcome measures were: (1) whether or not the intake occurred and (2) whether or not the intake occurred within the agreed-upon time period (correct timing). Multilevel logistic regression analyses were performed to account for the nested structure of the data.
Results
Medication intakes in the evening and during weekends and holidays were more likely to be incorrectly timed and also more likely to be completely missed. Irrespective of timing, most intakes occurred in the mornings of Monday through Thursday (96 %), and least intakes occurred on Saturday evening (82 %). Correctly timed intakes most often occurred on Monday and Tuesday mornings (61 %) in contrast to Sunday evenings (33 %). A patient’s medication regimen was significantly associated with adherence.
Conclusion
Based on our results, among patients who already have difficulties in taking their oral antidiabetic medication, interruptions in the daily routine negatively influence the intake of their medication. Professionals need to be aware of this variation in adherence within patients. As regular medication intake is important to maintain glycaemic control, healthcare professionals and patients should work together to find strategies that prevent deviations from the prescribed regimen at these problematic dosing times.
Keywords: Medication adherence, Oral antidiabetics, Multilevel modelling, Electronic monitoring
Original languageEnglish
Pages (from-to)1599-1606
JournalEuropean Journal of Clinical Pharmacology
Volume69
Issue number8
DOIs
Publication statusPublished - 2013

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Hypoglycemic Agents
Type 2 Diabetes Mellitus
Holidays
Medication Adherence
Pharmacies
Logistic Models
Delivery of Health Care

Cite this

@article{8267ae176516407b83a739814f76b79a,
title = "Lazy Sunday afternoons: the negative impact of interruptions in patients’ daily routine on adherence to oral antidiabetic medication. A multilevel analysis of electronic monitoring data",
abstract = "PurposeConsiderable variability in adherence over time exists. The aim of this study was to investigate to what extent deviations from the prescribed regimen in type 2 diabetes patients can be explained by characteristics of the individual ‘medication intake moments’ and the patient.MethodsMedication intake of 104 non-adherent type 2 diabetes patients from 37 community pharmacies was electronically monitored for 6 months. The primary outcome measures were: (1) whether or not the intake occurred and (2) whether or not the intake occurred within the agreed-upon time period (correct timing). Multilevel logistic regression analyses were performed to account for the nested structure of the data.ResultsMedication intakes in the evening and during weekends and holidays were more likely to be incorrectly timed and also more likely to be completely missed. Irrespective of timing, most intakes occurred in the mornings of Monday through Thursday (96 {\%}), and least intakes occurred on Saturday evening (82 {\%}). Correctly timed intakes most often occurred on Monday and Tuesday mornings (61 {\%}) in contrast to Sunday evenings (33 {\%}). A patient’s medication regimen was significantly associated with adherence.ConclusionBased on our results, among patients who already have difficulties in taking their oral antidiabetic medication, interruptions in the daily routine negatively influence the intake of their medication. Professionals need to be aware of this variation in adherence within patients. As regular medication intake is important to maintain glycaemic control, healthcare professionals and patients should work together to find strategies that prevent deviations from the prescribed regimen at these problematic dosing times.Keywords: Medication adherence, Oral antidiabetics, Multilevel modelling, Electronic monitoring",
author = "M. Vervloet and P. Spreeuwenberg and M. Bouvy and E.R. Heerdink and {de Bakker}, D.H. and {van Dijk}, L.",
year = "2013",
doi = "10.1007/s00228-013-1511-y",
language = "English",
volume = "69",
pages = "1599--1606",
journal = "European Journal of Clinical Pharmacology",
issn = "0031-6970",
publisher = "Springer Verlag",
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Lazy Sunday afternoons : the negative impact of interruptions in patients’ daily routine on adherence to oral antidiabetic medication. A multilevel analysis of electronic monitoring data. / Vervloet, M.; Spreeuwenberg, P.; Bouvy, M.; Heerdink, E.R.; de Bakker, D.H.; van Dijk, L.

In: European Journal of Clinical Pharmacology, Vol. 69, No. 8, 2013, p. 1599-1606.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Lazy Sunday afternoons

T2 - the negative impact of interruptions in patients’ daily routine on adherence to oral antidiabetic medication. A multilevel analysis of electronic monitoring data

AU - Vervloet, M.

AU - Spreeuwenberg, P.

AU - Bouvy, M.

AU - Heerdink, E.R.

AU - de Bakker, D.H.

AU - van Dijk, L.

PY - 2013

Y1 - 2013

N2 - PurposeConsiderable variability in adherence over time exists. The aim of this study was to investigate to what extent deviations from the prescribed regimen in type 2 diabetes patients can be explained by characteristics of the individual ‘medication intake moments’ and the patient.MethodsMedication intake of 104 non-adherent type 2 diabetes patients from 37 community pharmacies was electronically monitored for 6 months. The primary outcome measures were: (1) whether or not the intake occurred and (2) whether or not the intake occurred within the agreed-upon time period (correct timing). Multilevel logistic regression analyses were performed to account for the nested structure of the data.ResultsMedication intakes in the evening and during weekends and holidays were more likely to be incorrectly timed and also more likely to be completely missed. Irrespective of timing, most intakes occurred in the mornings of Monday through Thursday (96 %), and least intakes occurred on Saturday evening (82 %). Correctly timed intakes most often occurred on Monday and Tuesday mornings (61 %) in contrast to Sunday evenings (33 %). A patient’s medication regimen was significantly associated with adherence.ConclusionBased on our results, among patients who already have difficulties in taking their oral antidiabetic medication, interruptions in the daily routine negatively influence the intake of their medication. Professionals need to be aware of this variation in adherence within patients. As regular medication intake is important to maintain glycaemic control, healthcare professionals and patients should work together to find strategies that prevent deviations from the prescribed regimen at these problematic dosing times.Keywords: Medication adherence, Oral antidiabetics, Multilevel modelling, Electronic monitoring

AB - PurposeConsiderable variability in adherence over time exists. The aim of this study was to investigate to what extent deviations from the prescribed regimen in type 2 diabetes patients can be explained by characteristics of the individual ‘medication intake moments’ and the patient.MethodsMedication intake of 104 non-adherent type 2 diabetes patients from 37 community pharmacies was electronically monitored for 6 months. The primary outcome measures were: (1) whether or not the intake occurred and (2) whether or not the intake occurred within the agreed-upon time period (correct timing). Multilevel logistic regression analyses were performed to account for the nested structure of the data.ResultsMedication intakes in the evening and during weekends and holidays were more likely to be incorrectly timed and also more likely to be completely missed. Irrespective of timing, most intakes occurred in the mornings of Monday through Thursday (96 %), and least intakes occurred on Saturday evening (82 %). Correctly timed intakes most often occurred on Monday and Tuesday mornings (61 %) in contrast to Sunday evenings (33 %). A patient’s medication regimen was significantly associated with adherence.ConclusionBased on our results, among patients who already have difficulties in taking their oral antidiabetic medication, interruptions in the daily routine negatively influence the intake of their medication. Professionals need to be aware of this variation in adherence within patients. As regular medication intake is important to maintain glycaemic control, healthcare professionals and patients should work together to find strategies that prevent deviations from the prescribed regimen at these problematic dosing times.Keywords: Medication adherence, Oral antidiabetics, Multilevel modelling, Electronic monitoring

U2 - 10.1007/s00228-013-1511-y

DO - 10.1007/s00228-013-1511-y

M3 - Article

VL - 69

SP - 1599

EP - 1606

JO - European Journal of Clinical Pharmacology

JF - European Journal of Clinical Pharmacology

SN - 0031-6970

IS - 8

ER -