Arnold-Wörner N, Holle R, Rathmann W, Mielck A
GSF - National Research Center for Environment and Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany.
Exp Clin Endocrinol Diabetes. 2008 Feb;116(2):123-8. doi: 10.1055/s-2007-990297. Epub 2007 Oct 31.
This study aims to investigate the degree to which subjects with type 2 diabetes comply with treatment recommendations concerning diet, physical exercise and self-care, the consistency of compliance across different treatment areas, and the association of compliance with individual characteristics of patients and their medical treatment.
The sample consists of 345 type 2 diabetes patients who had been drawn from two population-based surveys (MONICA) and from a myocardial infarction registry in Southern Germany, and who have participated in a survey in 1997/98. Data were collected by interviews, questionnaires and medical exams. Pearson correlation and logistic regression analysis were applied to test the relationships. A compliance score was established by adding up the components of the treatment regimen.
Only one fifth of the subjects with type 2 diabetes showed good compliance in terms of the applied score. Compliance was highest in weight measuring and foot care, and poorest in following exercise recommendations, glucose testing, and recording the results. Overall, weak correlations were found between the components of the treatment regimen. Participation in diabetes education, regular consultation of physicians specialized in diabetes care, age (<70 years), and satisfaction with treatment were all associated with better compliance.
Correlation between the different components of compliance behaviour was low, indicating that compliance should not be measured by one component only. As compliance with the treatment recommendations was poor, education programs for type 2 diabetic subjects should be propagated and the cooperation with diabetes specialists should be promoted.
本研究旨在调查2型糖尿病患者在饮食、体育锻炼和自我护理方面遵循治疗建议的程度,不同治疗领域依从性的一致性,以及依从性与患者个体特征及其医疗治疗之间的关联。
样本包括345名2型糖尿病患者,他们来自两项基于人群的调查(MONICA)和德国南部的心肌梗死登记处,并于1997/98年参与了一项调查。通过访谈、问卷调查和医学检查收集数据。应用Pearson相关性分析和逻辑回归分析来检验这些关系。通过将治疗方案的各个组成部分相加来建立依从性评分。
就应用的评分而言,只有五分之一的2型糖尿病患者表现出良好的依从性。在体重测量和足部护理方面依从性最高,而在遵循运动建议、血糖检测和记录结果方面依从性最差。总体而言,治疗方案各组成部分之间的相关性较弱。参与糖尿病教育、定期咨询糖尿病专科医生、年龄(<70岁)以及对治疗的满意度均与更好的依从性相关。
依从行为不同组成部分之间的相关性较低,这表明不应仅通过一个组成部分来衡量依从性。由于对治疗建议的依从性较差,应推广针对2型糖尿病患者的教育项目,并促进与糖尿病专科医生的合作。