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2型糖尿病患者抗糖尿病治疗依从性差的预测因素:来自埃塞俄比亚的横断面研究洞察

Predictors of poor adherence to antidiabetic therapy in patients with type 2 diabetes: a cross-sectional study insight from Ethiopia.

作者信息

Demoz Gebre Teklemariam, Wahdey Shishay, Bahrey Degena, Kahsay Halefom, Woldu Gebremariam, Niriayo Yirga Legesse, Collier Andrew

机构信息

School of Pharmacy, College of Health Sciences, Aksum University, PO.Box: 298, Aksum, Ethiopia.

School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.

出版信息

Diabetol Metab Syndr. 2020 Jul 16;12:62. doi: 10.1186/s13098-020-00567-7. eCollection 2020.

Abstract

BACKGROUND

Poor adherence to the medical regimen is a major clinical problem in the management of patients with diabetes. This study sought to investigate the level of medication adherence to antidiabetic therapy and to identify possible predictors of poor adherence.

METHODS

A hospital based cross-sectional study was conducted from July 2018 to June 2019 among randomly selected follow-up T2D patients at a hospital diabetes clinic. Data were collected through patient interviews, followed by medical chart review. Adherence to antidiabetic therapy that we assessed patients' responses using validated Brief Medication Questionnaire (BMQ). To identify predictors of poor medication adherence, binary logistic regression analyses were performed using SPSS version 25. Statistical significance was set at value ≤ 0.05.

RESULTS

Of the total 357 study participants, 25% were non-adherent to their antidiabetic therapy. Predictors statistically associated with poor adherence were; being female gender (AOR = 1.71, 95% CI 1.01-2.76), and presence of at least one diabetic complication (AOR = 2.02, 95% CI 1.02-3.22). Participants with having at least primary level of education were more likely to adhere to anti-diabetes medication (AOR = 0.42, 95% CI 0.18-0.96). The most common self-reported reasons for non-adherence were forgetfulness, unavailability of medication plus the unaffordability of anti-diabetes medications.

CONCLUSIONS

The proportion of participants' adherent to anti-diabetes therapies was suboptimal. Being female, the presence of chronic diabetic complications and having no formal education were the main predictors of poor adherence. Strategies that aimed at improving adherence to antidiabetic medications deemed to be compulsory.

摘要

背景

糖尿病患者治疗方案依从性差是糖尿病管理中的一个主要临床问题。本研究旨在调查抗糖尿病治疗的药物依从性水平,并确定依从性差的可能预测因素。

方法

2018年7月至2019年6月,在一家医院糖尿病门诊对随机选取的2型糖尿病随访患者进行了一项基于医院的横断面研究。通过患者访谈收集数据,随后进行病历审查。我们使用经过验证的简明药物问卷(BMQ)评估患者对抗糖尿病治疗的依从性。为了确定药物依从性差的预测因素,使用SPSS 25版进行二元逻辑回归分析。统计学显著性设定为P值≤0.05。

结果

在总共357名研究参与者中,25%的人未坚持抗糖尿病治疗。与依从性差有统计学关联的预测因素包括:女性(比值比[AOR]=1.71,95%置信区间[CI]1.01 - 2.76),以及存在至少一种糖尿病并发症(AOR = 2.02,95% CI 1.02 - 3.22)。至少接受过小学教育的参与者更有可能坚持服用抗糖尿病药物(AOR = 0.42,95% CI 0.18 - 0.96)。最常见的自我报告的不依从原因是忘记服药、药物无法获取以及抗糖尿病药物费用负担不起。

结论

参与者对抗糖尿病治疗的依从比例不理想。女性、存在慢性糖尿病并发症以及未接受正规教育是依从性差的主要预测因素。旨在提高抗糖尿病药物依从性的策略被认为是必要的。

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