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患者报告的口服降糖药耐受性问题:与依从性、治疗满意度和健康相关生活质量的关系。

Patient-reported tolerability issues with oral antidiabetic agents: Associations with adherence; treatment satisfaction and health-related quality of life.

机构信息

AstraZeneca, LP, Wilmington, DE 19850, United States.

出版信息

Diabetes Res Clin Pract. 2010 Feb;87(2):204-10. doi: 10.1016/j.diabres.2009.11.023. Epub 2009 Dec 29.

DOI:10.1016/j.diabres.2009.11.023
PMID:20036433
Abstract

AIMS

The study's aim was to quantify prevalence of tolerability issues among patients with T2DM currently treated with OADs and to assess its association with treatment adherence, satisfaction and health-related quality of life (HRQL).

METHODS

Data were collected from the 2006-2008 US National Health and Wellness Survey and the Ailment Panel of Lightspeed Online Research, an internet-based questionnaire. Participants (N=2074) self-reported a diagnosis of T2DM, were >18 years of age and currently taking >1 OADs but not insulin, and spoke English.

RESULTS

The majority (71.7%) experienced at least 1 tolerability issue in the past 2 weeks; 49.7% experienced >2. Tolerability issues included signs/symptoms of hypoglycemia (57.2%), constipation/diarrhea (28%), headaches (25.6%), weight gain (22.9%) and water retention (21.0%). There was a significant association between the number of tolerability issues and both the likelihood of non-adherence (r=0.20, p<0.01) and reduced treatment satisfaction (r=-0.42, p<0.01). Each additional tolerability issue was associated with 28% greater likelihood of medication non-adherence. Constipation/diarrhea (b=-0.02, p<0.01) and symptoms of hypoglycemia (b=-0.08, p<0.01) were significantly associated with lower HRQL scores.

CONCLUSIONS

Optimizing OAD therapy of T2DM by improving tolerability may increase patient satisfaction, medication adherence and HRQL, and may increase the likelihood of attaining treatment goals.

摘要

目的

本研究旨在量化目前接受 OAD 治疗的 2 型糖尿病(T2DM)患者出现耐受性问题的流行率,并评估其与治疗依从性、满意度和健康相关生活质量(HRQL)之间的关系。

方法

数据来自 2006-2008 年美国国家健康和健康调查以及基于互联网的问卷 Lightspeed Online Research 的疾病面板。参与者(N=2074)自我报告患有 T2DM,年龄>18 岁,目前正在服用>1 种 OAD 但不使用胰岛素,且会讲英语。

结果

大多数(71.7%)患者在过去 2 周内至少出现 1 个耐受性问题;49.7%的患者出现>2 个耐受性问题。耐受性问题包括低血糖的体征/症状(57.2%)、便秘/腹泻(28%)、头痛(25.6%)、体重增加(22.9%)和水潴留(21.0%)。出现的耐受性问题数量与不依从治疗的可能性(r=0.20,p<0.01)和治疗满意度降低(r=-0.42,p<0.01)显著相关。每增加一个耐受性问题,不依从药物治疗的可能性就会增加 28%。便秘/腹泻(b=-0.02,p<0.01)和低血糖症状(b=-0.08,p<0.01)与 HRQL 评分显著相关。

结论

通过提高耐受性来优化 T2DM 的 OAD 治疗,可能会提高患者满意度、治疗依从性和 HRQL,并增加达到治疗目标的可能性。

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