(B-050) Evaluation of the implementation of medication adherence interventions in type 2 diabetes mellitus patients in Aruba and Curaçao: a mixed method study

Background: Many patients with Type 2 diabetes mellitus (T2DM) in Aruba and Curaçao do not adhere to their medication leading to a high prevalence of disease-related complications and increased health care costs. To enhance medication adherence, T2DM patients treated with oral antidiabetics received animated medication information followed by proactive telephone counseling from their community pharmacist.

Objectives: This study aimed to evaluate the implementation of these evidence-based interventions and to identify influencing factors.

Methods: A mixed-method approach was used to evaluate the implementation of these interventions in 12 community pharmacies in Aruba and Curaçao. Both quantitative and qualitative data were collected through semi-structured individual interviews and reflection meetings with the participating pharmacies during and after the 11-month intervention period. For the analysis, the RE-AIM framework domains, Reach, Adoption and Implementation as well as CFIR constructs were used.

Results: With a dropout rate of 17% of the participating pharmacies, the attrition rate was low. Preliminary analysis showed that a total of 300 patients received the intervention. Success factors for the implementation included the perceived need for useful information provision and patient counseling (tension for change) as well as gratitude expressed by patients (external incentives). Conversely, barriers to implementation included short staffing (available resources), digital shortcomings (intervention characteristics) and difficulties with behavioral change among personnel (the implementation climate).

Conclusions: The performance of interventions to enhance medication adherence in daily pharmacy practice was feasible. Pharmacies were engaged adopters of these interventions. However, to sustain and upscale these interventions the barriers identified should be addressed.