Department of Neurology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA; Department of Psychiatry, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA; Department of Ophthalmology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.
Department of Psychiatry and Human Behavior, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.
Am J Geriatr Psychiatry. 2018 Jul;26(7):812-816. doi: 10.1016/j.jagp.2018.03.012. Epub 2018 Mar 23.
To evaluate determinants of medication adherence and glycemic control in black patients with diabetes and mild cognitive impairment (MCI).
Cross-sectional study of 143 participants with mean age of 68.8 (SD: 6.7) years; 66.4% were women.
Eighty-seven participants (60.8%) self-reported medication nonadherence; they had more negative beliefs about medicines, greater diabetes-related distress, and more difficulty with daily living activities and affording medications than adherent participants. There were no group differences in cognition, depressive symptoms, or glycemic control. Glycemic control negatively correlated with regimen distress, emotional burden, interpersonal distress, beliefs that physicians overprescribe medications, and beliefs that medications are harmful.
Beliefs about medications, diabetes-related distress, functional disability, and medication affordability are associated with medication nonadherence in black individuals with diabetes and MCI. Interventions that respect personal health beliefs and compensate for impaired cognition may improve medication adherence and glycemic control in this population.
评估患有糖尿病和轻度认知障碍(MCI)的黑人患者药物依从性和血糖控制的决定因素。
横断面研究纳入了 143 名参与者,平均年龄为 68.8(标准差:6.7)岁;66.4%为女性。
87 名参与者(60.8%)报告存在药物不依从;他们对药物有更负面的看法,与糖尿病相关的痛苦更多,日常生活活动和负担药物费用的能力更差,而依从性参与者则没有这些问题。两组在认知、抑郁症状或血糖控制方面没有差异。血糖控制与治疗方案困扰、情绪负担、人际困扰、医生过度开药的信念以及药物有害的信念呈负相关。
对药物的信念、与糖尿病相关的痛苦、功能障碍和药物负担能力与患有糖尿病和 MCI 的黑人个体的药物不依从有关。尊重个人健康信念并弥补认知障碍的干预措施可能会改善该人群的药物依从性和血糖控制。