Manan Mohamed Mansor, Husin Akhma Radzuanna, Alkhoshaiban Ali Saleh, Al-Worafi Yaser Mohammed Ali, Ming Long Chiau
Professor, Faculty of Pharmacy, Universiti Teknologi MARA , Puncak Alam, Malaysia .
Master Graduate, Faculty of Pharmacy, Universiti Teknologi MARA , Puncak Alam, Malaysia .
J Clin Diagn Res. 2014 Dec;8(12):JC05-9. doi: 10.7860/JCDR/2014/10481.5309. Epub 2014 Dec 5.
Adherence to medications is an important factor that contributes to therapeutic success. With the current increase in the elderly population, information relating to adherence to treatment and quality of life (QoL) of diabetic elderly patients will help the healthcare provider to improve their treatment. Thus, this study aims to determine the factors affecting adherence to medications and the consequence of non adherence to QoL.
This was a cross-sectional study using validated Morisky Medication Adherence Scale (MMAS) Questionnaire. This study was conducted to assess the level of adherence on oral hypoglycemic medications (OHM) and quality of life of the Type 2 diabetes mellitus (T2DM) elderly patients in an urban health centre in Malaysia. A retrospective medication record review was also conducted to collect and confirm data on patients' demographics, diagnosis, treatments, and outcomes.
One hundred and seventy nine patients were recruited in this study. Median adherence score was 7.75 (IQR 6.50- 8.00). Good adherer was observed in 48.00% of the participants. A Chi-square test indicated significant correlation between adherence and HbA1c (p= 0.010). The mean elderly diabetes mellitus Problem Areas in Diabetes (PAID) score was 6.30 ±SD 8.50. A significant inversed association was observed between PAID score and the level of adherence (r = - 0.175, p< 0.05). A highly significant difference in the low adherence group (p = 0.002). PAID score significantly correlated with age (years), female gender and HbA1c (p <0.05). A negative association between HbA1c levels and adherence was identified where a 1% increase in HbA1c was associated with a 30% decrease in the likelihood of being adherent.
A medication adherence rate of 48% was obtained among elderly T2DM patients treated in the primary care clinic. This study showed that HbA1c is a relevant tool to assess patient glycemic control and adherence. Sociodemographic characteristics were not statistically significantly associated with adherence. We reported a negative correlation between adherence and T2DM related emotional distress. The identified factors that relieve emotional distress of the elderly T2DM patients are similar with the western countries.
药物依从性是促成治疗成功的一个重要因素。随着当前老年人口的增加，有关糖尿病老年患者治疗依从性和生活质量（QoL）的信息将有助于医疗保健提供者改善他们的治疗。因此，本研究旨在确定影响药物依从性的因素以及不依从对生活质量的影响。
这是一项使用经过验证的莫里isky药物依从性量表（MMAS）问卷的横断面研究。本研究旨在评估马来西亚一个城市健康中心2型糖尿病（T2DM）老年患者口服降糖药（OHM）的依从性水平和生活质量。还进行了回顾性药物记录审查，以收集和确认有关患者人口统计学、诊断、治疗和结果的数据。
本研究招募了179名患者。中位依从性得分为7.75（四分位间距6.50 - 8.00）。48.00%的参与者表现为依从性良好。卡方检验表明依从性与糖化血红蛋白（HbA1c）之间存在显著相关性（p = 0.010）。糖尿病老年患者糖尿病问题领域（PAID）的平均得分是6.30±标准差8.50。观察到PAID得分与依从性水平之间存在显著的负相关（r = - 0.175，p < 0.05）。低依从性组存在高度显著差异（p = 0.002）。PAID得分与年龄（岁）、女性性别和HbA1c显著相关（p < 0.05）。确定了HbA1c水平与依从性之间的负相关关系，即HbA1c每增加1%，依从的可能性降低30%。
在初级保健诊所接受治疗的老年T2DM患者中，药物依从率为48%。本研究表明，HbA1c是评估患者血糖控制和依从性的一个相关工具。社会人口统计学特征与依从性无统计学显著关联。我们报告了依从性与T2DM相关情绪困扰之间的负相关关系。所确定的缓解老年T2DM患者情绪困扰的因素与西方国家相似。
