Comparing the cost, glycaemic control and medication adherence of utilizing patients' own medicines (POMs) versus usual dispensing among diabetic patients in an outpatient setting.
BACKGROUND
Millions worth of unused drugs particularly those indicated for chronic diseases such as diabetes were returned and disposed leading to substantial wastage. Use of patients' own medications (POMs) in the inpatient setting has reduced wastage and saved cost. The impact of utilizing POMs in the outpatient setting has hitherto not been determined.


PURPOSE
This study aims to compare the cost, medication adherence and glycaemic control of utilizing POMs versus usual dispensing.


METHODS
Prospective randomized controlled study was conducted among diabetic patients that required monthly medication refill in the Outpatient Pharmacy in 2017. Patients who consented were equally divided into POMs and control groups. Both groups brought excess medications from home at week-0 and week-12. Patients in the POMs group brought excess medications monthly and sufficient amount of drugs were added until the next refill date. Drugs were dispensed as usual in the control group. Total cost consisting of the cost of drugs, staff and building was calculated. Glycosylated haemoglobin (HbA1c) was measured at baseline and week-12. Adherence was measured based on pill counting.


RESULTS
Thirty patients aged 56.77 ± 14.67 years with 13.37 ± 7.36 years of diabetes participated. Baseline characteristics were similar between the groups. POMs minimized the total cost by 38.96% which translated to a cost saving of USD 42.76 ± 6.98, significantly different versus USD 0.02 ± 0.52 in the control group, p = 0.025. Mean HbA1c reduced significantly (-0.79%, p = 0.016) in the POMs group but not significant in the control group (-0.11%, p = 0.740). Medication adherence improved significantly in both groups at week-12 (p < 0.010). Nevertheless, patients in the POMs group were more adherent, 87.20% vs. 66.32%, p = 0.034.


CONCLUSION
Utilizing POMs resulted in cost saving, improved adherence and better glycaemic control. Use of POMs should be practiced in the outpatient pharmacy to reduce wastage and cost.
['Lim|Phei Ching|PC|', 'Chung|Yin Ying|YY|', 'Tan|Shien Joo|SJ|', 'Wong|Te Ying|TY|', 'Permalu|Durga Devi|DD|', 'Cheah|Thean Kheng|TK|', 'Lim|Shueh Lin|SL|', 'Lee|Chong Yew|CY|http://orcid.org/0000-0003-0632-3794']
D000328:Adult D000368:Aged D003365:Costs and Cost Analysis D003924:Diabetes Mellitus, Type 2 D004363:Drug Utilization D005260:Female D000085002:Glycemic Control D006801:Humans D007004:Hypoglycemic Agents D008297:Male D055118:Medication Adherence D008875:Middle Aged D010045:Outpatients
Cost Glycaemic control Medication adherence Outpatient Patients’ own medicines