Quality Standards for Diabetes Care Toolkit

Consider referral to diabetes care team or specialists

Assess patient adherence (see Standards 4 and 5)

Non-adherence with medications can limit the success of therapy and help to explain why a patient is not achieving treatment goals. To screen for non-adherence, clinicians can ask patients open-ended, non-threatening questions at each office visit. The assessment should include probes for factors that can contribute to non-adherence (fear of adverse reactions, misunderstanding of chronic disease treatment, depression, cognitive impairment, complex dosing regimens, or financial constraints):

assess the patient’s knowledge of their condition and their expectations for treatment

assess the patient’s medication administration process

assess the patient’s barriers to adherence.

Interventions to enhance medication adherence should be directed at risk factors or causes of non-adherence. Interventions may include simplifying the medication regimen, using reminder systems, involving family/whānau or caregivers in care, involving multiple disciplines in team care, providing written and verbal medication instructions, setting collaborative goals with patients, and providing education about medications (including potential adverse effects) and about diabetes in general.