While completing her graduate degree, Diva Niaz, a new MSc grad in the Faculty of Pharmacy and Pharmaceutical Sciences, got to combine her passions for research and clinical work, so when it came time to find a thesis topic, it was natural that she found inspiration from her interactions with patients.
“That’s the beauty of working in a community pharmacy—you’re helping individuals manage their chronic conditions,” she said. “I noticed that some patients diagnosed with diabetes required more followup and I was curious to know whether their drug adherence patterns could serve as a clue for other risk factors, such as depression.”
Niaz examined Alberta Health administrative data between 2008 and 2018. Of 165,056 individuals diagnosed with Type 2 diabetes and prescribed an oral medication, 10.5 per cent also received a depression-related service within at least one year. By determining adherence to multiple oral diabetes medications using a “proportion of days covered” calculation, Niaz was able to analyze whether these individuals had poor adherence.
“Symptoms of depression may persist for a long time before actually being recognized and diagnosed,” Niaz said. “We found individuals with depression were more likely to have poor medication adherence in the year prior to their diagnosis compared to those who did not have a depression diagnosis.”
Niaz’s findings that monitoring how people with Type 2 diabetes take their medication may provide clues to their mental health were recently published in an academic journal.
“This could flag pharmacists and other health-care professionals to intervene sooner and improve medication adherence, in hopes of preventing future negative clinical outcomes for these individuals.”
Good communication most important tool
Niaz, who also did her undergraduate degree at the U of A, works as a registered prescribing pharmacist and plans to continue supporting research. She said her degree will help her be more innovative and adaptive as she stays on top of developments in her profession.
“Part of being a pharmacist is lifelong, continuous learning to provide the most up-to-date information for patients,” she said. “My own research gives me the confidence to be able to provide evidence-based recommendations based on being able to understand and distinguish rigorous studies.”
Niaz said she was fortunate to have two thesis supervisors: Candace Necyk, a clinical associate professor with expertise in mental health, and Scot Simpson, a professor with expertise in diabetes research.
She also credited her family’s support as a motivation for her studies. Her family emigrated from Russia when Niaz was nine years old. Trained as a doctor, her mother, Latifa Niaz-Stadelman, now works as a massage therapist in Canada. She has always stressed the value of education and hard work to Diva and her brother, Kambez Niaz.
Coming full circle, Niaz said the biggest lesson she will take away from her research is how important it is to develop a relationship with patients and be able to use screening tools to intervene when appropriate.
“Previously, I was mostly focused on explaining each medication and providing detailed information on what to expect or what to monitor for when using the medication during counselling sessions,” she said. “Now, I also take the time to assess whether individuals understand the importance of the dose, and I try to create an opportunity for them to communicate how they are taking their medications.”
“Patients who have a good relationship with their health professionals are likely more comfortable to ask for help when they need it, and health professionals may also pick up on when someone’s motivation or interest in managing their chronic conditions changes.”