Prevent diabetes patients from slipping through the cracks

Getting diabetes patients to follow their treatment plans to the letter can be challenging, as evidenced by the high rate of nonadherence for chronic conditions overall. According to the World Health Organization (WHO), half of all medications for chronic diseases such as diabetes mellitus are not taken as prescribed.1

All that nonadherence comes at a cost. Medication nonadherence accounts for more than 10%of older adult hospital admissions, nearly one-fourth of nursing home admissions, and 20% of preventable adverse drug events among older persons in the ambulatory setting. It’s estimated that medication nonadherence results in 125,000 deaths annually and costs the US healthcare system $100 billion per year.2,3

Although some nonadherence is unintentional—including reasons such as forgetfulness or inability to pay for medications—nonadherence can also be attributed to mistrust of drug companies or the healthcare system, mental illness, fear of side effects, and misinformation about a drug.

And nonadherence isn’t limited to medications. Diabetes patients in particular may be reluctant to follow through with testing because they don’t want their physician to know they’ve slipped in terms of medication, diet or other elements of their treatment plan.

The good news is that there are strategies you can try to keep diabetes patients from slipping through the cracks:

Change it up. Instead of directly asking a patient whether they’re taking their meds as directed, ask the question in different ways: “Some of my patients find it hard to take their medicines every day. How about you? Do you find it difficult?” “I’m always looking for new tips and tricks to share with my other patients about how to remember to take their meds. Do you do anything special?” Asking indirectly can help a patient respond truthfully while also saving face.

Offer patients a “pill card.” The Agency for Healthcare Research and Quality (AHRQ) provides a print-ready pill card that gives patients a convenient checklist with which they may keep track of medications. The card is downloadable in either Word or PDF file formats here.

Go digital. Refer patients to handy digital tools that help them keep track of their blood glucose, A1C and other test results. Examples: the American Diabetes Association’s Diabetes 24/7 online tool or the Quest Diagnostics MyQuestTM patient app, which also suggests steps to take to enjoy better health.

Prompt patients for testing. Enroll diabetes patients in Quest’s TestMinder®, a convenient and timely service that reminds patients of frequent test appointments by email, text, or phone call. TestMinder can lead to fewer missed appointments and less staff time making phone calls.

Turn misinformed to informed. The reality is that patients will search online for answers in addition to speaking with you. Rather than dismiss all online information out of hand, refer patients to sites you know offer well-researched, well-vetted health information, such as government sites like or These resources typically reinforce the value of following doctor’s orders.

Keep it SIMPLE. Last, remember this model for improving medication adherence offered by the American College of Preventive Medicine. Much of it can apply to testing adherence as well:4

S Simplify the regimen

I Impart knowledge

M Modify patient beliefs and behavior

P Provide communication and trust

L Leave the bias*

E Evaluate adherence

Successful diabetes treatment requires long-term commitment on the part of both physician and patient. Quest can support you across the prediabetes-diabetes care continuum with comprehensive testing and clinical expertise to help you take action. For more information, visit our prediabetes and diabetes testing services pages.


*This refers to taking into account a patient’s health literacy and examining your self-efficacy in the care of racial, ethnic and social minority populations.

1 World Health Organization (WHO). Adherence to long-term therapies: evidence for action. Available at Accessed July 18, 2016.
2 Sources: Ho 2009, Circulation. Non-adherence causes ~30% to 50% of treatment failures and 125,000 deaths annually.
3 American Society on Aging and American Society of Consultant Pharmacists Foundation. Available at
4 American College of Preventive Medicine. Medication Adherence Time Tool: Improving Health Outcomes. A Resource from the American College of Preventive Medicine. Available at Accessed October 26, 2016.

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