Improvement diabetes medication care through optimization collaboration GP and Pharmacy staff: development of a protocol (WC2017-068)

Background

Starting date: 01/09/2017

 About half of the patients that use medication for long-term conditions have adherence issues. Although several interventions (e.g. e-health, electronic reminder systems, counselling) have shown to improve adherence in randomized clinical trials, few interventions have been scaled up and implemented in clinical practice. 


The successful implementation of adherence improving interventions often not only includes the patient but even more so the health care professional (HCP) and health care organization (HCO). Successful implementation, however, is also complicated by the large variation in patients’ reasons for not adhering to a prescribed regimen. In line with Mendys et al [1] we argue that interventions are likely to be implemented more successfully when, in addition to meeting the needs of individual patients as a primary condition, use is made of specific knowledge and skills of the HCP and a stimulating HCO is created. It is therefore essential to tailor an intervention to both the needs of individual patients and the qualities of the HCP and HCO, and address eventual shortcomings in knowledge and (communication) skills of the HCP. In addition, good collaboration between HCPs is essential for the performance and fidelity of interventions. 

 

Our previous study on the development of a tailored intervention (HOUVAST) to support non-adherent diabetes type 2 (DM2) patients with the use of their medication showed that poor communication and collaboration between general practitioners and community pharmacists were main obstacles for implementation in daily clinical practice.[2] Additionally, research by NIVEL and SIR among community pharmacists and general practitioners shows that in case they suspect non-adherence they often do not contact each other. The present proposal builds on these previous results and will focus more detailed on the facilitators and barriers of the collaboration between pharmacists/pharmacy technicians and GPs/ nurse practitioners, behavioural support and communication skills of these HCPs.      

1. Mendys, P (2014). Patient Prefer Adherence, 8, 1025-1034/      
2. Adhien, P (2013). Int J Clin Pharm, 35(6), 1113-1119/