Elsous Aymen, Radwan Mahmoud, Al-Sharif Hasnaa, Abu Mustafa Ayman
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences - International campus, Tehran, Iran.
Quality Improvement and Infection Control Office, Shifa Medical Complex, Gaza Strip, Palestine.
Front Endocrinol (Lausanne). 2017 Jun 9;8:100. doi: 10.3389/fendo.2017.00100. eCollection 2017.
The aim of this study was to evaluate the adherence to anti-diabetic medications among patients with type 2 diabetes mellitus (DM) seeking medical care in the Gaza Strip, Palestine.
A cross-sectional study was conducted among 369 primary care patients with type 2 DM from October to December 2016. Adherence to medications was measured using the Morisky Medication Adherence Scale (MMAS-4). Socio-demographic and clinical variables, provider-patient relationship, health literacy, and health belief were examined for each patient. Univariate, binary logistic regression and multiple linear regression were applied to determine the independent factors influencing adherence to anti-diabetic medications using SPSS version 22.
Of all the respondents, 214 (58%), 146 (39.5%), and nine (2.5%) had high (MMAS score = 0), medium (MMAS score = 1 + 2), and low (MMAS score ≥ 3) adherence to anti-diabetic medications, respectively. Factors that were independently associated with adherence to anti-diabetic medications were as follows: female gender [odds ratio (OR): 1.657, 95% confidence interval (CI): 1.065-2.578] and perception of disease's severity (OR: 1.510, 95% CI: 0.410-5.560). Elderly ( = 1.345) and longer duration of DM ( = 0.899) were also predictors of adherence but showed no statistical significance ( > 0.05).
The level of complete adherence to anti-diabetic medications was sub-optimal. New strategies that aim to improve patients' adherence to their therapies are necessary taking into consideration the influencing factors and the importance of having diabetes educators in the primary care centers.
本研究旨在评估在巴勒斯坦加沙地带寻求医疗服务的2型糖尿病（DM）患者中抗糖尿病药物的依从性。
2016年10月至12月对369例2型糖尿病初级护理患者进行了横断面研究。使用Morisky药物依从性量表（MMAS-4）测量药物依从性。对每位患者的社会人口统计学和临床变量、医患关系、健康素养和健康信念进行了检查。使用SPSS 22版进行单因素、二元逻辑回归和多元线性回归，以确定影响抗糖尿病药物依从性的独立因素。
在所有受访者中，分别有214例（58%）、146例（39.5%）和9例（2.5%）对抗糖尿病药物的依从性高（MMAS评分=0）、中（MMAS评分=1+2）和低（MMAS评分≥3）。与抗糖尿病药物依从性独立相关的因素如下：女性[比值比（OR）：1.657，95%置信区间（CI）：1.065-2.578]和对疾病严重程度的认知（OR：1.510，95%CI：0.410-5.560）。老年人（=1.345）和糖尿病病程较长（=0.899）也是依从性的预测因素，但无统计学意义（>0.05）。
抗糖尿病药物的完全依从性水平不理想。考虑到影响因素以及在初级保健中心配备糖尿病教育工作者的重要性，有必要制定旨在提高患者治疗依从性的新策略。
