Sleath Betsy, Carpenter Delesha M, Blalock Susan J, Davis Scott A, Hickson Ryan P, Lee Charles, Ferreri Stefanie P, Scott Jennifer E, Rodebaugh Lisa B, Cummings Doyle M
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, USA; Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, USA.
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, USA.
Patient Prefer Adherence. 2016 Jun 7;10:1003-10. doi: 10.2147/PPA.S101349. eCollection 2016.
Although there are several different general diabetes self-efficacy scales, there is a need to develop a self-efficacy scale that providers can use to assess patient's self-efficacy regarding medication use. The purpose of this study was to: 1) develop a new diabetes medication self-efficacy scale and 2) examine how diabetes medication self-efficacy is associated with patient-reported problems in using diabetes medications and self-reported adherence.
Adult English-speaking patients with type 2 diabetes were recruited from a family medicine clinic and a pharmacy in Eastern North Carolina, USA. The patients were eligible if they reported being nonadherent to their diabetes medicines on a visual analog scale. Multivariable regression was used to examine the relationship between self-efficacy and the number of reported diabetes medication problems and adherence.
The diabetes medication self-efficacy scale had strong reliability (Cronbach's alpha =0.86). Among a sample (N=51) of mostly African-American female patients, diabetes medication problems were common (6.1±3.1) and a greater number of diabetes medications were associated with lower medication adherence (odds ratio: 0.35; 95% confidence interval: 0.13, 0.89). Higher medication self-efficacy was significantly related to medication adherence (odds ratio: 1.17; 95% confidence interval: 1.05, 1.30) and inversely related to the number of self-reported medication problems (β=-0.13; P=0.006).
Higher diabetes medication self-efficacy was associated with fewer patient-reported medication problems and better medication adherence. Assessing medication-specific self-efficacy may help to identify medication-related problems that providers can help the patients address, potentially improving adherence and patient outcomes.
尽管有几种不同的一般糖尿病自我效能量表,但仍需要开发一种供医疗服务提供者用于评估患者在药物使用方面自我效能的量表。本研究的目的是:1)开发一种新的糖尿病药物自我效能量表;2)研究糖尿病药物自我效能与患者报告的糖尿病药物使用问题及自我报告的依从性之间的关联。
从美国北卡罗来纳州东部的一家家庭医学诊所和一家药房招募说英语的成年2型糖尿病患者。如果患者在视觉模拟量表上报告自己未坚持服用糖尿病药物,则符合入选条件。采用多变量回归分析来研究自我效能与报告的糖尿病药物问题数量及依从性之间的关系。
糖尿病药物自我效能量表具有很强的信度(克朗巴哈系数α=0.86)。在一个主要为非裔美国女性患者的样本(N=51)中,糖尿病药物问题很常见(6.1±3.1),且更多的糖尿病药物与更低的药物依从性相关(比值比:0.35;95%置信区间:0.13,0.89)。更高的药物自我效能与药物依从性显著相关(比值比:1.17;95%置信区间:1.05,1.30),与自我报告的药物问题数量呈负相关(β=-0.13;P=0.006)。
更高的糖尿病药物自我效能与患者报告的药物问题较少及更好的药物依从性相关。评估特定药物的自我效能可能有助于识别医疗服务提供者可帮助患者解决的与药物相关的问题,从而有可能提高依从性和改善患者预后。