Osborn Chandra Y, Gonzalez Jeffery S
Department of Medicine, Department of Biomedical Informatics, Center for Health and Health Education, Vanderbilt University Medical Center, 2525 West End Ave. Suite 370, Nashville, TN, 37203, USA.
Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA.
J Behav Med. 2016 Aug;39(4):633-41. doi: 10.1007/s10865-016-9741-y. Epub 2016 Apr 9.
Non-adherence to insulin is common and associated with suboptimal health. We adapted the Morisky Medication Adherence Scale to specify insulin adherence (MIAS) and compared it to the Adherence to Refills and Medication Scale for Diabetes (ARMS-D) and the Summary of Diabetes Self-Care Activities medications subscale (SDSCA-MS) and an insulin-specific (SDSCA-IS) version. A sample of 144 insulin-treated adults (58 % African American/Black, 34 % Caucasian/White, 8 % Other/Mixed race; 6.9 % Hispanic) completed these measures along with a HbA1C test. The internal consistency and factor structure of the MIAS were adequate; 59 % of participants forgot to take insulin and 46 % reported non-adherence. The MIAS was associated with the ARMS-D, SDSCA-MS, and SDSCA-IS (p < 0.001), and higher MIAS scores were marginally associated with better self-rated health (p = 0.057), but significantly associated with fewer emergency room visits (p = 0.001), and better HbA1C (p = 0.001). The MIAS is a valid and reliable insulin adherence assessment tool for practice and research applications.
胰岛素治疗依从性不佳很常见，且与健康状况欠佳有关。我们对莫利斯基药物依从性量表进行了调整，以明确胰岛素治疗依从性（MIAS），并将其与糖尿病药物续方与治疗依从性量表（ARMS-D）、糖尿病自我护理活动药物分量表（SDSCA-MS）以及胰岛素专用版本（SDSCA-IS）进行比较。144名接受胰岛素治疗的成年人样本（58%为非裔美国人/黑人，34%为白种人/白人，8%为其他/混血种族；6.9%为西班牙裔）完成了这些测量以及糖化血红蛋白（HbA1C）检测。MIAS的内部一致性和因子结构良好；59%的参与者忘记注射胰岛素，46%的参与者报告存在治疗依从性不佳的情况。MIAS与ARMS-D、SDSCA-MS和SDSCA-IS相关（p<0.001），MIAS得分越高与自我健康评分越好呈微弱相关（p=0.057），但与急诊就诊次数越少显著相关（p=0.001），且与更好的糖化血红蛋白水平相关（p=0.001）。MIAS是一种用于实践和研究应用的有效且可靠的胰岛素治疗依从性评估工具。
