Objective: The purpose of this study was to test the psychometric properties of the M-DRAW tool and to examine its applicability and utility at a primary clinic setting in patients with diabetes.
Methods: A prospective, pre-post interview design study was conducted at the VA Loma Linda Health System (VALLHS) from 03/2017-03/2018. Eligibility criteria consisted of English-speaking patrons who were 18 years and older, diagnosed with Type 2 diabetes mellitus, residing in non-institutional setting, and having 1 + prescriptions for diabetes. A priming question about self-reported adherence was used to assign participants to control (Group A) or intervention (Group N). Pharmacist-led interventions were thus directed to those who recognized their medication nonadherence issue. The M-DRAW tool consisted of 13 statements about barriers to adherence on a 4-point frequency scale. A "3 = sometimes" or "4 = often" on each item indicated a barrier to adherence that was then addressed using the GUIDE strategy using motivational interviewing with the participant.
Results: Of the 200 eligible individuals, 88 participants completed both baseline and follow-up assessments (Group A, n = 63; Group N, n = 25). Participants were male (98.8%), taking 7-8 medications on average, and using insulin (79.5%). The tool yielded good internal consistency (Cronbach's alpha = 0.873). Using confirmatory factor analysis, four factors were extracted with items loading as hypothesized. At baseline, group N identified three times greater number of barriers from the M-DRAW tool compared to Group A (5.1 items vs. 1.7, p < 0.05). At 3-month follow-up, a decrease in the number of barriers was observed among Group N. Both PDC and HbA1c did not result in statistically significant reduction in pre-post change.
Conclusions: The M-DRAW tool is shown to be reliable and valid. A tailored intervention reduced the number of barriers contributing to medication nonadherence and resulted in a trend of improved clinical outcomes.
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http://dx.doi.org/10.1016/j.sapharm.2019.09.063 | DOI Listing |
Res Social Adm Pharm
July 2020
Western University of Health Sciences, College of Pharmacy, Department of Pharmacy Practice and Administration, 309 East Second Street., Pomona, CA, 91766, USA. Electronic address:
Objective: The purpose of this study was to test the psychometric properties of the M-DRAW tool and to examine its applicability and utility at a primary clinic setting in patients with diabetes.
Methods: A prospective, pre-post interview design study was conducted at the VA Loma Linda Health System (VALLHS) from 03/2017-03/2018. Eligibility criteria consisted of English-speaking patrons who were 18 years and older, diagnosed with Type 2 diabetes mellitus, residing in non-institutional setting, and having 1 + prescriptions for diabetes.
Pharmacy (Basel)
September 2017
College of Pharmacy, Western University of Health Sciences, Pomona, CA 91766, USA.
Barriers to medication adherence stem from multiple factors. An effective and convenient tool is needed to identify these barriers so that clinicians can provide a tailored, patient-centered consultation with patients. The Modified Drug Adherence Work-up Tool (M-DRAW) was developed as a 13-item checklist questionnaire to identify barriers to medication adherence.
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