Investigating the Impact of a Mental Health Adherence Intervention on Mental Health Medication Adherence in Patients with Diabetes

Abstract

Specific Aims: Evaluate the impact of targeted psychotropic medication adherence interventions by pharmacists on psychotropic medication adherence rates in patients with type 2 diabetes and determine whether patient-specific variables, such as age, gender, or type of psychotropic medication being taken, influence the degree of impact. Methods: Adherence, as indicated by proportion of days covered (PDC), was measured before and after face-to-face counseling by a community pharmacist. Pharmacists were alerted to counsel patients receiving Medicare Part D prescription coverage who were prescribed a psychotropic medication and exhibited a PDC of <85%. Data regarding PDC, age, gender, and type of psychotropic medication were analyzed for patients between 18 and 84 years of age with type 2 diabetes. Main Results: The data set contained 8,167 patients eligible for analysis, including 5,438 women (mean age=63.6 years, SD=11.5) and 2,729 men (mean age=61.6 years, SD=10.3). There was significant improvement in PDC after pharmacist intervention overall (mean PDC increase=13.5%, SD=20.2, p<0.01) and for each subgroup, with the exception of nefazodone (n=3, p=0.66). Patients 65 years and older showed the greatest improvement (PDC change=14.5, p<0.01), followed by patients aged 40-64 years (PDC change=12.5, p<0.01) and then 20-39 years (PDC change=9.1, p<0.01). Conclusions: Targeted face-to-face interventions by pharmacists significantly improved psychotropic medication adherence in adult patients with type 2 diabetes receiving Medicare Part D prescription coverage. Improvement was seen regardless of gender, age, or type of psychotropic medication, except nefazodone, and was greater with increasing age. The degree of improvement also varied among certain psychotropic medications.