Educational interventions aiming at improving adherence to treatment recommendations in type 2 diabetes : A sub-analysis of a systematic review of randomised controlled trials

Objective: In the management of type 2 diabetes, a complex interaction takes place between medical professionals' treatment goals and patients' health beliefs about the disease and its treatment options. The contribution of self-management education to adherence in general or even more specifically to medicine taking is not known. We assessed educational interventions aimed at improving adherence to medical treatment recommendations, other than lifestyle advice. Study design: Systematic literature review. Setting: This paper represents an analysis of eight articles describing an educational intervention as a subgroup of a Cochrane Review [E. Vermeire, J. Wens, P. Van Royen, Y. Biot, H. Hearnshaw, A. Lindenmeyer, Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus, Cochrane Database of Systematic Reviews 2005, Issue 2, Art. No.: CD003638, doi:10.1002/14651858.CD003638.pub2] on interventions to improve adherence to treatment recommendations in people with type 2 diabetes. Results: Four studies reported interventions using face-to-face education, two reported on the effects of group education and two on distance education by telemedicine. Due to poor quality of study designs, a variety of heterogeneous outcome measures in different time intervals, unclear definitions of adherence, and difficulties in evaluating different aspects of education performed, general conclusions could not be drawn. Conclusion: Consistent conclusions about the effectiveness of educational interventions on adherence to treatment recommendations were hard to be drawn. There is an urgent need for well-designed intervention studies on the effect of different aspects of education on adherence to treatment recommendations. (C) 2007 Elsevier Ireland Ltd. All rights reserved