Suzuki Ryo, Saita Shun, Nishigaki Nobuhiro, Kisanuki Koichi, Shimasaki Yukio, Mineyama Tomoka, Odawara Masato
Department of Diabetes Endocrinology and Metabolism, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.
Japan Medical Office, Japan Pharma Business Unit, Takeda Pharmaceutical Company Limited, 2-1-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8668, Japan.
Diabetes Ther. 2021 Sep;12(9):2343-2358. doi: 10.1007/s13300-021-01100-3. Epub 2021 Jul 20.
To identify factors associated with treatment adherence and satisfaction in patients with type 2 diabetes (T2DM) in Japan.
A web-based questionnaire survey was conducted from 6 to 17 March 2019 in patients with T2DM aged ≥ 20 years receiving diabetes treatment. Treatment adherence and satisfaction were self-assessed/reported by the patients. A multiple logistic regression model and the chi-square test were used to assess associated factors.
Responders (N = 1000) were aged 63.8 (standard deviation 11.9) years, and 739 (73.9%) were male. Adherence to treatment was reported in 941 (94.1%) patients and was significantly associated with higher household income (odds ratio [OR] 2.07, 95% confidence interval [CI] 1.11-3.86), age (OR 1.04, 95% CI 1.02-1.07), employment (OR 0.30, 95% CI 0.15-0.60) and having ≥ 1 impaired basic activity of daily living (BADL) (OR 0.33, 95% CI 0.13-0.82). Satisfaction with treatment was reported by 575 (57.5%) and was significantly associated with receiving/understanding guidance on how pharmacologic therapies are tailored (OR 1.73, 95% CI 1.19-2.51), male sex (OR 1.55, 95% CI 1.10-2.19), higher household income (OR 1.45, 95% CI 1.09-1.94) and age (OR 1.02, 95% CI 1.00-1.03). Treatment adherence was negatively associated with lower household income and having ≥ 1 impaired BADL in patients aged < 65 years, but not in those aged ≥ 65 years. Treatment satisfaction was positively associated with higher household income and receiving/understanding guidance on exercise therapy and the importance of achieving target haemoglobin A1c levels in patients aged ≥ 65 years, but with receiving/understanding guidance on the tailoring of pharmacologic therapies in patients aged < 65 years.
Lower age, lower household income, employment and impaired BADL may negatively impact treatment adherence in patients with T2DM. Appropriate physician guidance may promote treatment satisfaction. Differences in perspectives between patients aged < 65 and those aged ≥ 65 years should be considered.
Japan Pharmaceutical Information Center, JapicCTI-194636.
确定日本2型糖尿病（T2DM）患者治疗依从性和满意度的相关因素。
于2019年3月6日至17日对年龄≥20岁正在接受糖尿病治疗的T2DM患者进行了一项基于网络的问卷调查。治疗依从性和满意度由患者自行评估/报告。采用多重逻辑回归模型和卡方检验评估相关因素。
1000名应答者的年龄为63.8岁（标准差11.9），其中739名（73.9%）为男性。941名（94.1%）患者报告了治疗依从性，其与较高的家庭收入（比值比[OR]2.07，95%置信区间[CI]1.11 - 3.86）、年龄（OR 1.04，95% CI 1.02 - 1.07）、就业情况（OR 0.30，95% CI 0.15 - 0.60）以及存在≥1项日常生活基本活动（BADL）受损（OR 0.33，95% CI 0.13 - 0.82）显著相关。575名（57.5%）患者报告了对治疗的满意度，其与接受/理解关于药物治疗如何个体化的指导（OR 1.73，95% CI 1.19 - 2.51）、男性（OR 1.55，95% CI 1.10 - 2.19）、较高的家庭收入（OR 1.45，95% CI 1.09 - 1.94）和年龄（OR 1.02，95% CI 1.00 - 1.03）显著相关。在年龄<65岁的患者中，治疗依从性与较低的家庭收入以及存在≥1项BADL受损呈负相关，但在年龄≥65岁的患者中并非如此。在年龄≥65岁的患者中，治疗满意度与较高的家庭收入以及接受/理解关于运动疗法和实现目标糖化血红蛋白A1c水平重要性的指导呈正相关，但在年龄<65岁的患者中与接受/理解关于药物治疗个体化的指导呈正相关。
较低的年龄、较低的家庭收入、就业情况以及BADL受损可能对T2DM患者的治疗依从性产生负面影响。适当的医生指导可能会提高治疗满意度。应考虑年龄<65岁和≥65岁患者之间观点的差异。
日本药物信息中心，JapicCTI - 194636。
