2型糖尿病基层医疗患者口服降糖药的依从模式与血糖控制情况
Patterns of Adherence to Oral Hypoglycemic Agents and Glucose Control among Primary Care Patients with Type 2 Diabetes.
作者信息
de Vries McClintock Heather F, Morales Knashawn H, Small Dylan S, Bogner Hillary R
机构信息
a Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine , University of Pennsylvania; Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania.
b Department of Biostatistics and Epidemiology, Perelman School of Medicine , University of Pennsylvania.
出版信息
Behav Med. 2016;42(2):63-71. doi: 10.1080/08964289.2014.904767. Epub 2014 Oct 10.
Researchers sought to examine whether there are patterns of oral hypoglycemic-agent adherence among primary-care patients with type 2 diabetes that are related to patient characteristics and clinical outcomes. Longitudinal analysis via growth curve mixture modeling was carried out to classify 180 patients who participated in an adherence intervention according to patterns of adherence to oral hypoglycemic agents across 12 weeks. Three patterns of change in adherence were identified: adherent, increasing adherence, and nonadherent. Global cognition and intervention condition were associated with pattern of change in adherence (p < .05). Patients with an increasing adherence pattern were more likely to have an Hemoglobin A1c (HbA1c) < 7%; adjusted odds ratio = 14.52, 95% CI (2.54, 82.99) at 12 weeks, in comparison with patients with the nonadherent pattern. Identification of patients with type 2 diabetes at risk of nonadherence is important for clinical prognosis and the development and delivery of interventions.
研究人员试图探讨2型糖尿病初级保健患者中口服降糖药依从性模式是否与患者特征及临床结局相关。通过生长曲线混合模型进行纵向分析，以根据12周内口服降糖药的依从模式对180名参与依从性干预的患者进行分类。确定了三种依从性变化模式：依从、依从性增加和不依从。整体认知和干预条件与依从性变化模式相关（p < .05）。与不依从模式的患者相比，依从性增加模式的患者更有可能糖化血红蛋白（HbA1c）< 7%；在12周时调整后的优势比 = 14.52，95%置信区间（2.54，82.99）。识别有不依从风险的2型糖尿病患者对于临床预后以及干预措施的制定和实施很重要。
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