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资源匮乏地区2型糖尿病患者口服降糖药的依从性

Adherence to Oral Hypoglycemic Drugs among Type 2 Diabetic Patients in a Resource-Poor Setting.

作者信息

Sefah Israel Abebrese, Okotah Archibald, Afriyie Daniel Kwame, Amponsah Seth Kwabena

机构信息

Department of Pharmacy, Keta Municipal Hospital, Ghana Health Service, Keta, Ghana.

Department of Pharmacy, Ho Municipal Hospital, Ghana Health Service, Ho, Accra, Ghana.

出版信息

Int J Appl Basic Med Res. 2020 Apr-Jun;10(2):102-109. doi: 10.4103/ijabmr.IJABMR_270_19. Epub 2020 Apr 2.

Abstract

OBJECTIVE

Diabetes mellitus is a growing public health problem in many countries including Ghana. Adherence to drugs, especially among patients with type 2 diabetes mellitus (T2DM) is often poor is some resource-poor settings. The objective of this study was to assess adherence to oral hypoglycemic drugs and factors that affect adherence among patients with T2DM in the Volta Region of Ghana.

METHODS

The study was cross-sectional and conducted among 400 patients with T2DM attending diabetic clinics at 4 randomly selected hospitals in the Volta Region of Ghana between January 10 and March 30, 2015. Patients were interviewed using a structured questionnaire and other data collection tools to determine the commonest self-reported reason(s) for nonadherence. Adherence was assessed using the 8-item Morisky Medication Adherence Scale. Multivariate analysis was performed between adherence and statistically significant patient variables.

RESULTS

Adherence to oral hypoglycemic drugs among T2DM patients was 47.75%. The odds of adherence with fasting blood glucose between 1 and 6 mmol/L was approximately two-fold (adjusted odd ratio [aOR] =1.92, confidence interval [CI]: 1.11-3.32) versus the odds of having fasting blood glucose of above 10 mmol/L. The odds of adherence among patients with tertiary education was approximately three-fold (aOR = 3.01 CI: 1.44-6.269) versus patients with no formal education. The commonest self-reported reason for nonadherence was forgetfulness.

CONCLUSION

Adherence to oral hypoglycemic drugs among T2DM patients in the current study was sub-optimal. Therefore, in such settings, management of T2DM must include strategies to identify nonadherent patients, and regular patient education and counseling.

摘要

目的

在包括加纳在内的许多国家,糖尿病已成为一个日益严重的公共卫生问题。在一些资源匮乏地区,患者对药物的依从性,尤其是2型糖尿病(T2DM)患者,往往较差。本研究的目的是评估加纳沃尔特地区T2DM患者对口服降糖药的依从性以及影响依从性的因素。

方法

本研究为横断面研究,于2015年1月10日至3月30日期间,在加纳沃尔特地区随机选取的4家医院的糖尿病诊所中,对400例T2DM患者进行了调查。通过结构化问卷和其他数据收集工具对患者进行访谈,以确定最常见的自我报告的不依从原因。使用8项Morisky药物依从性量表评估依从性。对依从性与具有统计学意义的患者变量进行多变量分析。

结果

T2DM患者对口服降糖药的依从率为47.75%。空腹血糖在1至6 mmol/L之间的患者的依从几率约为空腹血糖高于10 mmol/L患者的两倍(调整后的优势比[aOR]=1.92,置信区间[CI]:1.11 - 3.32)。受过高等教育的患者的依从几率约为未接受正规教育患者的三倍(aOR = 3.01,CI:1.44 - 6.269)。最常见的自我报告的不依从原因是遗忘。

结论

本研究中T2DM患者对口服降糖药的依从性欠佳。因此,在这种情况下,T2DM的管理必须包括识别不依从患者的策略,以及定期的患者教育和咨询。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26f1/7289204/c418cbeb87b5/IJABMR-10-102-g001.jpg

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