Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Diabet Med. 2010 Feb;27(2):210-6. doi: 10.1111/j.1464-5491.2009.02898.x.
To assess pharmacy claims and self-report data as measures of medication adherence and to describe baseline characteristics of subjects in the Improving Diabetes Outcomes Study.
Multi-ethnic, lower-income, insured adults (n = 526) in New York City with Type 2 diabetes were enrolled in a randomized, controlled, behavioural intervention study delivered by telephone. Baseline data were examined, including glycated haemoglobin (HbA(1c)), objective measures of diabetes medication adherence [claims data medication possession ratio (MPR)], and two self-report measures [Morisky Medication-taking Scale and the medication-taking item of the Summary of Diabetes Self-Care Activities (SDSCA)]. Associations of highest tertile HbA(1c) (>or= 9.3%) with lowest tertile MPR (< 42%) were assessed with logistic regression models adjusting for potential confounders. Subset analyses were performed based on assessment of potential interaction.
Participants (mean +/- sd age 56 +/- 7 years) had median (interquartile range) HbA(1c) 8.6% (8.0-10.0). Correlations of baseline MPR with Morisky score and SDSCA medication-taking item were strongly significant (both rho = 0.21, P < 0.001). Lowest MPR was significantly (P = 0.008) associated with highest HbA(1c) in the group as a whole and among the subset taking two or more oral glucose-lowering agents (OGLA) (P = 0.002), but not among the subset taking only one (P = 0.83). Self-report adherence measures were not significantly associated with HbA(1c) in either the whole group or either subset.
These results support the validity of MPR as an adherence measure for OGLA among insured diabetes patients with poorly controlled HbA(1c), especially those taking two or more OGLA.
评估药房理赔数据和自我报告数据作为药物依从性的测量手段，并描述改善糖尿病结局研究中受试者的基线特征。
在纽约市，对患有 2 型糖尿病的多民族、低收入、有保险的成年人（n = 526）进行了一项随机、对照、行为干预研究。检查了基线数据，包括糖化血红蛋白（HbA1c）、客观的糖尿病药物依从性测量（理赔数据药物持有率（MPR））以及两个自我报告的测量（Morisky 用药量表和糖尿病自我护理活动总结（SDSCA）的用药项目）。使用逻辑回归模型调整潜在混杂因素，评估最高三分位 HbA1c（> 9.3%）与最低三分位 MPR（< 42%）之间的关联。基于对潜在交互作用的评估，进行了亚组分析。
参与者（平均年龄 56 +/- 7 岁）的中位数（四分位间距）HbA1c 为 8.6%（8.0-10.0）。基线 MPR 与 Morisky 评分和 SDSCA 用药项目的相关性非常显著（两者的 rho 值均为 0.21，P < 0.001）。在整个组和服用两种或更多种口服降糖药（OGLA）的亚组中（P = 0.008），最低的 MPR 与最高的 HbA1c 显著相关（P = 0.002），但在仅服用一种 OGLA 的亚组中则没有相关性（P = 0.83）。在整个组或任何亚组中，自我报告的依从性测量与 HbA1c 均无显著相关性。
这些结果支持 MPR 作为保险糖尿病患者 HbA1c 控制不佳时 OGLA 依从性的测量手段，特别是服用两种或更多种 OGLA 的患者。
