Universidad Internacional de La Rioja, 26006, Logroño, Spain.
Centro de Salud Las Fuentes Norte, Servicio Aragonés de Salud (SALUD), 50002, Zaragoza, Spain.
Sci Rep. 2021 Apr 26;11(1):8889. doi: 10.1038/s41598-021-87410-9.
Diabetic patients have increased depression rates, diminished quality of life, and higher death rates due to depression comorbidity or diabetes complications. Treatment adherence (TA) and the maintenance of an adequate and competent self-care are crucial factors to reach optimal glycaemic control and stable quality of life in these patients. In this report, we present the baseline population analyses in phase I of the TELE-DD project, a three-phased population-based study in 23 Health Centres from the Aragonian Health Service Sector II in Zaragoza, Spain. The objectives of the present report are: (1) to determine the point prevalence of T2D and clinical depression comorbidity and treatment nonadherence; (2) to test if HbA1c and LDL-C, as primary DM outcomes, are related to TA in this population; and (3) to test if these DM primary outcomes are associated with TA independently of shared risk factors for DM and depression, and patients' health behaviours. A population of 7,271 patients with type-2 diabetes and comorbid clinical depression was investigated for inclusion. Individuals with confirmed diagnoses and drug treatment for both illnesses (n = 3340) were included in the current phase I. A point prevalence of 1.9% was found for the T2D-depression comorbidity. The prevalence of patients nonadherent to treatment for these diseases was 35.4%. Multivariate analyses confirmed that lower diabetes duration, increased yearly PCS visits, HbA1c and LDL-C levels were independently related to treatment nonadherence. These findings informed the development of a telephonic monitoring platform for treatment of nonadherence for people with diabetes and comorbid depression and further trial, cost-effectiveness, and prognostic studies (phases II and III).
糖尿病患者由于抑郁共病或糖尿病并发症而导致抑郁发生率增加、生活质量下降和死亡率升高。治疗依从性（TA）和维持充足和胜任的自我护理是达到这些患者最佳血糖控制和稳定生活质量的关键因素。在本报告中，我们介绍了 TELE-DD 项目第一阶段的基线人群分析，这是一项在西班牙萨拉戈萨的阿拉贡卫生服务部门 II 的 23 个卫生中心进行的三阶段基于人群的研究。本报告的目的是：（1）确定 T2D 和临床抑郁症共病及治疗不依从的时点患病率；（2）检验该人群中主要 DM 结局（HbA1c 和 LDL-C）与 TA 是否相关；（3）检验这些 DM 主要结局是否与 TA 相关，而不受 DM 和抑郁的共同危险因素以及患者健康行为的影响。调查了 7271 名患有 2 型糖尿病和合并临床抑郁症的患者，以确定是否符合纳入标准。对确诊且两种疾病均接受药物治疗的个体（n=3340）进行了当前第一阶段的纳入。T2D-抑郁症共病的时点患病率为 1.9%。这些疾病治疗不依从的患者患病率为 35.4%。多变量分析证实，糖尿病病程较短、每年 PCS 就诊次数增加、HbA1c 和 LDL-C 水平升高与治疗不依从独立相关。这些发现为开发针对患有糖尿病和合并抑郁症的患者的电话监测平台以治疗不依从提供了信息，并进一步开展了试验、成本效益和预后研究（第二和第三阶段）。
