Gentil Lia, Vasiliadis Helen-Maria, Berbiche Djamal, Préville Michel
Faculty of Medicine and Health Sciences, Sherbrooke University, 150 Place Charles-Le Moyne bureau 200, C.P. 11, Longueuil, QC J4K 0A8 Canada.
Research Center, Charles LeMoyne Hospital, Longueuil, QC Canada.
Eur J Ageing. 2016 Jul 23;14(2):111-121. doi: 10.1007/s10433-016-0390-3. eCollection 2017 Jun.
The prevalence of diabetes mellitus is increasing in Canada, and nonadherence to oral hypoglycemics is a common problem among older adults. This study aims to document the impact of depression and anxiety disorders on adherence to oral hypoglycemics in older adults with diabetes mellitus. Data used in this study came from the longitudinal Quebec survey on senior's health (Enquête sur la Santé des Ainés), using a representative sample of 2811 older adults aged 65 and over. The final sample for analysis consisted of 301 patients who received oral hypoglycemic pharmacotherapy. Medication adherence was measured with the medication possession ratio. An adapted version of Andersen's behavioral model was used to explain adherence to oral hypoglycemic medication while considering the following predisposing factors: age, gender, and level of education: enabling factors: marital status and income level: and need factors: physical and mental health status. Our explanatory model of oral hypoglycemic medication adherence was tested using a latent growth curve model. The results of the multiple-group analysis did not show any significant difference in oral hypoglycemic medication adherence (p > 0.05). Furthermore, individuals with higher levels of education were less adherent to oral hypoglycemics than those with lower levels of education (p < 0.05). Medication adherence to oral hypoglycemics did not show any significant difference between participants with and without depression and anxiety disorders. Future studies with larger samples are needed to fully explore the association between mental disorders and oral hypoglycemic medication adherence in the older adult populations.
加拿大糖尿病的患病率正在上升,而老年人不坚持服用口服降糖药是一个常见问题。本研究旨在记录抑郁症和焦虑症对老年糖尿病患者口服降糖药依从性的影响。本研究中使用的数据来自魁北克老年人健康纵向调查(Enquête sur la Santé des Ainés),样本为2811名65岁及以上的老年人,具有代表性。最终用于分析的样本包括301名接受口服降糖药物治疗的患者。用药依从性通过药物持有率来衡量。采用安德森行为模型的一个改编版本来解释口服降糖药物的依从性,同时考虑以下 predisposing因素:年龄、性别和教育水平; enabling因素:婚姻状况和收入水平;以及需求因素:身心健康状况。我们使用潜在增长曲线模型对口服降糖药物依从性的解释模型进行了测试。多组分析结果显示,口服降糖药物依从性没有显著差异(p>0.05)。此外,教育水平较高的个体比教育水平较低的个体口服降糖药依从性更低(p<0.05)。有或没有抑郁症和焦虑症的参与者在口服降糖药的用药依从性方面没有显著差异。需要进行更大样本量的未来研究,以充分探索老年人群中精神障碍与口服降糖药物依从性之间的关联。