Use of Therapy Diary as a Method for Monitoring and Improving Adherence to Metformin Therapy in Diabetic Patients

Aims: To determine the effectiveness of using a therapy diary in improving adherence and blood glucose levels.

Study Design: A randomized multicenter study.

Place and Duration of Study: The research was conducted in the primary Health Centers of ​​Tuzla Canton from March to August 2024.

Methodology: This study involved 44 participants, age 35-65, who had previously been diagnosed with type 2 diabetes mellitus. Included participants used metformin irregularly for at least 6 months and had not been diagnosed with a malignant disease or a severe mental disorder. Every participant gave written consent to participate in the research. A therapy diary was used as a method for monitoring adherence to metformin over a period of 3 months. Participants were trained to independently measure and record blood glucose level with a glucometer every morning for 3 months.

Results: 32 (72.73%) participants had adherence greater than 80% after 3 months, while 12 (27.27%) had adherence less than 80%, which is considered insufficient. The mean value of blood glucose level for all participants at the beginning of the study was 8.9 mmol/L. The mean value of morning blood glucose level for all participants after 3 months was 0.6 mmol/l lower. The mean value of morning blood glucose level in adherent patients after 3 months was 8.2 mmol/L, which shows that morning glucose level decreased by 0.7 mmol/L on average. The mean value of morning blood glucose level in non-adherent patients was 9.1 mmol/L, which is on average 0.2 mmol/L higher than the mean value of measured blood glucose level at the beginning of the study.

Conclusion: These results indicate that using a therapy diary can help with identification of trends in patient’s blood glucose levels and medication adherence, but further research is needed to establish more successful methods for improving adherence in diabetic patients.