S Arulmozhi, T Mahalakshmy
Intern, Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital , Puducherry, India .
Assistant Professor, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, India .
J Clin Diagn Res. 2014 Apr;8(4):UC01-3. doi: 10.7860/JCDR/2014/7732.4256. Epub 2014 Apr 15.
Micro and macro-vascular complications of Type 2 Diabetes mellitus (DM) could be decreased by maintaining a good glycaemic control, which is dependent on adherence to medication and self care.
(1) To assess medication adherence and adherence to self care among type 2 diabetics who were admitted to a tertiary care hospital (2) To identify factors which were associated with medication adherence.
This descriptive study involved 150 in-patients of Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), a teaching hospital in Puducherry, southern India. Subjects who had type 2 DM for more than 1 month were included in the study, irrespective of their diagnoses at admission. They were interviewed within 24 hours of their admissions by using a pre-designed, pre-tested, structured questionnaire. The questionnaire included Morisky Medication Adherence Scale (MMAS) and questions for assessing adherence to self care activities. The factors which were associated with medication adherence were identified by Chi-square test and logistic regression.
The mean age of the subjects was 54 years. Only 49.3% (95% CI: 41% to 57%) of the diabetics had high medication adherence (MMAS score = 8). Only 22.7% of the diabetics were involved in physical exercise for at least 30 minutes, for at least 4 days in a week. Only 16.7% of them regularly inspected their feet. Around 67.3% of the subjects reported about consuming a diabetic diet for at least 4 days/week. Poor family support showed a significant association with low medication adherence.
Only 49.3% of the subjects adhered to anti-diabetic medications. Less than 25% of the diabetics adhered to self care activities such as exercising/walking for 30 minutes on at least 4 days in a week, regularly inspected their feet and provided feet care. Family support played a vital role in medication adherence among the diabetic subjects. Hence, it is important to regularly assess patients for medication adherence and include their families also in counseling sessions.
通过维持良好的血糖控制可降低2型糖尿病（DM）的微血管和大血管并发症，而这依赖于药物治疗依从性和自我护理。
（1）评估入住三级护理医院的2型糖尿病患者的药物治疗依从性和自我护理依从性 （2）确定与药物治疗依从性相关的因素。
这项描述性研究纳入了印度南部本地治里一家教学医院——斯里马纳库拉·维奈亚加尔医学院及医院（SMVMCH）的150名住院患者。患有2型糖尿病超过1个月的患者被纳入研究，无论其入院时的诊断情况如何。在他们入院后24小时内，使用预先设计、预先测试的结构化问卷对他们进行访谈。该问卷包括莫斯基药物治疗依从性量表（MMAS）以及评估自我护理活动依从性的问题。通过卡方检验和逻辑回归确定与药物治疗依从性相关的因素。
受试者的平均年龄为54岁。仅有49.3%（95%置信区间：41%至57%）的糖尿病患者具有高药物治疗依从性（MMAS评分 = 8）。仅有22.7%的糖尿病患者每周至少有4天进行至少30分钟的体育锻炼。仅有16.7%的患者定期检查足部。约67.3%的受试者报告每周至少有4天遵循糖尿病饮食。家庭支持不足与低药物治疗依从性显著相关。
仅有49.3%的受试者坚持服用抗糖尿病药物。不到25%的糖尿病患者坚持自我护理活动，如每周至少4天进行30分钟的锻炼/散步、定期检查足部并进行足部护理。家庭支持在糖尿病患者的药物治疗依从性方面起着至关重要的作用。因此，定期评估患者的药物治疗依从性并让其家人参与咨询会议很重要。
