Meraya Abdulkarim M, Makeen Hafiz A
Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Saudi Arabia.
Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Saudi Arabia.
Prev Med Rep. 2019 Mar 30;14:100857. doi: 10.1016/j.pmedr.2019.100857. eCollection 2019 Jun.
Previous studies indicated that a high proportion of adults with diabetes do not receive recommended preventive care in the United States. Nevertheless, a comprehensive evaluation of the factors associated with the receipt of most recommended preventive care measures collectively is lacking. Therefore, this study describes the utilization of multiple preventive care measures collectively. Moreover, this paper aims to identify factors associated with receiving the recommended preventive care. A cross-sectional study design was implemented using data from multiple panels (2009-2015) of the Medical Expenditure Panel Survey. The sample included adults aged 21 years or older with diabetes ( = 8415). The outcome for this study was either receiving five selected preventive care measures (HbA1c tests, cholesterol tests, foot examinations, dilated eye examinations, and influenza vaccines) collectively or not. Multivariable logistic regressions were performed among all adults with diabetes, those with multimorbidity, chronic kidney disease (CKD) or eye complications. Adults with diabetes were poorly adherent to receiving the five preventive care measures collectively (15.6%). Among all adults with diabetes, factors associated with receiving all the selected preventive practices included age, education, health insurance, prescription drug coverage, duration of diabetes, number of chronic conditions and smoking status. Similar results were observed among adults with multimorbidity. Among adults with CKD, those with private insurance and drug prescription coverage were more likely to receive the recommended practices. The findings suggest low adherence to receiving all five recommended practices. It is crucial to increase the awareness about the need for all the recommended practices among adults with diabetes.
先前的研究表明，在美国，很大一部分糖尿病成年人未接受推荐的预防性护理。然而，目前缺乏对与综合接受大多数推荐预防性护理措施相关因素的全面评估。因此，本研究描述了综合使用多种预防性护理措施的情况。此外，本文旨在确定与接受推荐预防性护理相关的因素。采用横断面研究设计，使用医疗支出面板调查多个小组（2009 - 2015年）的数据。样本包括21岁及以上的糖尿病成年人（n = 8415）。本研究的结果是是否综合接受五项选定的预防性护理措施（糖化血红蛋白检测、胆固醇检测、足部检查、散瞳眼科检查和流感疫苗）。对所有糖尿病成年人、患有多种疾病、慢性肾脏病（CKD）或眼部并发症的成年人进行了多变量逻辑回归分析。糖尿病成年人综合接受这五项预防性护理措施的依从性较差（15.6%）。在所有糖尿病成年人中，与接受所有选定预防措施相关的因素包括年龄、教育程度、医疗保险、处方药覆盖范围、糖尿病病程、慢性病数量和吸烟状况。在患有多种疾病的成年人中也观察到了类似结果。在患有CKD的成年人中，拥有私人保险和药物处方覆盖的人更有可能接受推荐的措施。研究结果表明对接受所有五项推荐措施的依从性较低。提高糖尿病成年人对所有推荐措施必要性的认识至关重要。
