Authors (including presenting author) :
Liu WSA(1)(2), Lam YH(1)(2), Cheung SM(1)(2), Huang HY(1)(2), Ho SY(1)(2), Tam KLR(1)(2), Au KYS(1)(2), Lam YFD(2), Ng ML(2), Pang HK(1)(2), Lau YFE(1)(2)
Affiliation :
(1) Diabetes Ambulatory Centre, Department of Medicine, Pamela Youde Nethersole Eastern Hospital, (2) Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Keyword 1: :
Enhance medication adherence
Keyword 2: :
Older adults with diabetes
Introduction :
Diabetes mellitus (DM) is a global health concern, affecting a significant portion of elderly population. As people age and cognitive abilities decline, they may experience medication non-adherence, including wrong dose, missed dose or medication discontinuation. Older adults with DM are admitted for hyperglycemia or hypoglycemia mostly due to medication non-adherence or age-related complications. Hyperglycemia and severe hypoglycemia not only diminish quality of life, but also increase hospitalization rates, morbidity and mortality. Therefore, enhancing medication adherence in older adults through empowerment is imperative for effective DM management.
Objectives :
- Enhance medication adherence - Empower diabetes self-care - Reduce hospital admissions related to DM medication adherence
Methodology :
This pre-and post-intervention program was conducted from July to September 2025, targeting older adults attending diabetes nurse clinic or nurse consultation for inpatients with fair or poor medication adherence. The program involved three face-to-face nurse clinic sessions and two follow-up phone call sessions over a three-month period. The empowerment consisted of tailored education, a 10-item multiple-choice question for patient to assess DM medication knowledge, a patient satisfactory survey, and the use of validated Morisky 8-Item Medication Adherence Questionnaire (MMAS-8) to evaluate adherence levels: 8 (high adherence), 6 to < 8 (medium adherence), and < 6 (low adherence). All materials used have undergone validation by expert panel.
Result & Outcome :
Fifteen patients recruited with average age of 72.27±5.62 years old and average diabetes duration of 16.27±11.53 years. Fourteen patients completed the empowerment program, while one patient died. Nine were male. Only one patient had type 1 DM, while the others had type 2 DM. Following the program, the total number of admissions related to DM medication adherence dropped from four in the preceding three months to zero. Significant improved in fasting glucose (6.88 to 6.74 mmol/L) and HbA1c (7.89 to 7.29%). Additionally, the mean MMAS-8 score from 5.32 (low adherence) to 7.18 (medium adherence), while the mean score of multiple-choice question increased from 6.93 to 9.93 out of 10. Participants expressed high satisfaction, highlighting increased knowledge and alleviated anxiety regarding DM medication by the evaluation. Empowering patients with personalized educational interventions to enhance medication adherence and diabetes self-care management significantly reduces hospital admissions and healthcare cost burden. A broader adoption of this approach in daily practice could benefit a larger patient population.
