Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P.O. Box LG 43, Legon, Ghana.
Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P.O. Box GP 4236, Accra, Ghana.
J Diabetes Res. 2020 Mar 1;2020:4760624. doi: 10.1155/2020/4760624. eCollection 2020.
Type 2 diabetes mellitus (T2DM) is a major public health problem associated with distress. T2DM can affect health outcomes and adherence to medications. Little is however known about the association between diabetes distress and medication adherence among patients with T2DM in Ghana.
The objective of the present study is twofold: to estimate distress associated with T2DM and to examine its association with medication adherence.
A hospital-based cross-sectional study was conducted among 188 patients with T2DM recruited from a diabetes specialist outpatient clinic at the Pantang Hospital in Accra, Ghana. Data were obtained using the Problem Areas In Diabetes (PAID) scale and the Medication Adherence Report Scale.
The findings showed that about 44.7% of the patients showed high levels of diabetes-related distress. Poor adherence to medications was recorded in 66.5% of the patients. Patients who were highly distressed had 68% lower odds of adhering to their medications compared to those who were not (OR: 0.32, 95% CI: 0.15-0.65). A principal component analysis revealed four areas of T2DM distress which were conceptualized as negative emotions about diabetes, dietary concerns and diabetes care, dissatisfaction with external support, and diabetes management helplessness.
Our findings suggest that diabetes distress is a significant determinant of medication adherence behaviour in patients with T2DM. Thus, incorporating routine screening for distress into the standard diabetes care within the Ghanaian health system and having health practitioners adopt holistic approaches to diabetes management will be important context-specific interventions to improve adherence and health outcomes of people living and coping with T2DM.
2 型糖尿病（T2DM）是一个与痛苦相关的主要公共卫生问题。T2DM 会影响健康结果和对药物的依从性。然而，在加纳，人们对 T2DM 患者的糖尿病困扰与药物依从性之间的关系知之甚少。
本研究旨在评估与 T2DM 相关的困扰，并研究其与药物依从性的关系。
在加纳阿克拉潘唐医院的糖尿病专科门诊对 188 例 T2DM 患者进行了一项基于医院的横断面研究。使用糖尿病问题领域量表（PAID）和药物依从性报告量表获取数据。
研究结果显示，约 44.7%的患者存在较高水平的与糖尿病相关的困扰。66.5%的患者药物依从性差。与未出现高度困扰的患者相比，高度困扰的患者服药依从性降低了 68%（OR：0.32，95%CI：0.15-0.65）。主成分分析揭示了 T2DM 困扰的四个方面，分别是对糖尿病的负面情绪、饮食担忧和糖尿病护理、对外界支持的不满以及糖尿病管理无助。
我们的研究结果表明，糖尿病困扰是 T2DM 患者药物依从行为的重要决定因素。因此，在加纳卫生系统中，将常规筛查困扰纳入标准糖尿病护理，并让医疗保健从业者采用整体方法管理糖尿病，这将是改善 T2DM 患者的依从性和健康结果的重要特定于情境的干预措施。
