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Public health interventions on prescription redemptions and secondary medication adherence among type 2 diabetes patients: systematic review and meta-analysis of randomized controlled trials

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Journal of Diabetes & Metabolic Disorders Aims and scope Submit manuscript

Abstract

Background

Despite the inadequate filling of prescriptions among chronic care patients has been a problem, little is known about the intervention effect on it.

Objective

The aim of this systematic review and meta-analysis (SRMA) was to investigate the effectiveness of various public health interventions on primary and secondary medication adherence among T2DM patients.

Methods

Searching was done from the major databases; Cochrane Library, Medline/PubMed, EBSCOhost, and SCOPUS. A hand search was made to find grey works of literature. Articles focused on interventions to enhance primary and secondary medication among type 2 diabetes mellitus patients were included. After screening and checking eligibility, the methodological quality was assessed. Secondary medication adherence was synthesized descriptively due to measurement and definition variations across studies. Finally, a meta-analysis was made using the fixed effects model for primary medication adherence.

Results

3992 studies were screened for both primary and secondary medication adherences. Among these, 24 studies were included in the analysis for primary (5) and secondary (19) medication adherence. Pooled relative medication redemption difference was RD = 8% (95% CI: 6–11%) among the intervention groups. Age, intervention, provider setting, and IDF region were determinant factors of primary medication adherence. About two-thirds of the studies revealed that interventions were effective in improving secondary medication adherence.

Conclusion

Both primary and secondary medications were enhanced by a variety of public health interventions for patients worldwide. However, there is a scarcity of studies on primary medication adherence globally, and in resource-limited settings for the type of adherences.

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Data availability

The generated datasets and/or analyzed are ready for concerning parts from the corresponding author when necessary.

Abbreviations

BMI:

Body mass index

BP:

Blood pressure

CG:

Control group

DBP:

Diastolic blood pressure

FPG:

Fasting plasma glucose

HbA1c:

Glycated haemoglobin

HDL-C:

High density lipids cholesterol

HIT:

Health information technology

IDF:

International Diabetes Federation

IG:

Intervention group

ITT:

Intention-to-treat analysis

LDL-C:

Low density lipids cholesterol

MA:

Medication adherence

MMAS:

Morisky Medication Adherence Scale

MENA:

Middle East and Northern Africa

MPR:

Medication possession ration

NAC:

North America and Caribbean

PHC:

Primary health care

PPG:

Postprandial glucose

RCT:

Randomized control trial

SBP:

Systolic blood pressure

TG:

Triglyceride

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Authors and Affiliations

  1. Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary

    Bayu Begashaw Bekele

  2. Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia

    Bayu Begashaw Bekele, Biruk Bogale, Samuel Negash, Melkamsew Tesfaye, Dawit Getachew & Tewodros Yosef

  3. Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

    Bayu Begashaw Bekele

  4. Department of Public Health, College of Health Science, Ethiopian Defence University, Addis Ababa, Ethiopia

    Fekede Weldekidan

Authors
  1. Bayu Begashaw Bekele
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  2. Biruk Bogale
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  3. Samuel Negash
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  4. Melkamsew Tesfaye
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  5. Dawit Getachew
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  6. Fekede Weldekidan
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  7. Tewodros Yosef
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Contributions

Bekele BB conceived, drafted, managed, and analyzed the study, BBB, SN, MT, DG, FW, BBB & BB formal investigation, methodology and drafted and reviewed the manuscript. All authors edited and finally approved the manuscript.

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Correspondence to Bayu Begashaw Bekele.

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Supplementary Information

ESM 1

Appendix I Key terms, databases and searching strategy. Appendix II JBI Data Extraction Form for Experimental Studies. Supplementary I 8 points Jadad scores of the included studies on Primary medication adherence. Supplementary II is the figure that denotes the sensitivity analysis (DOCX 78 kb)

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Bekele, B.B., Bogale, B., Negash, S. et al. Public health interventions on prescription redemptions and secondary medication adherence among type 2 diabetes patients: systematic review and meta-analysis of randomized controlled trials. J Diabetes Metab Disord 20, 1933–1956 (2021). https://doi.org/10.1007/s40200-021-00878-0

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