Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG, 43 Legon, Ghana.
J Diabetes Res. 2021 Aug 6;2021:9941538. doi: 10.1155/2021/9941538. eCollection 2021.
Optimal adherence to prescribed medications in women with gestational diabetes is relevant for perinatal outcomes.
To summarize available information on the prevalence and factors contributing to medication adherence in women with gestational diabetes from the biological and psychosocial perspectives.
A literature search on adherence in gestational diabetes was conducted in PubMed/MEDLINE, CINAHL, Scopus, and the Directory of Open Access Journals for studies published on the topic. The Arksey and O'Malley framework for scoping reviews was used to explore and summarize the evidence.
A total of 2395 studies were retrieved of which 13 fully met the eligibility criteria. The studies were reported in Zimbabwe ( = 5), Iran ( = 1), Mexico ( = 1), South India ( = 1), the United States of America ( = 4), and one multinational study covering Australia, Europe, North and South America. The main types of antidiabetic medications used were insulin ( = 6), metformin ( = 4), and glyburide ( = 2). The prevalence of adherence ranged from 35.6% to 97%, with the assessment tool being self-report measures ( = 8). The main factors associated with nonadherence included worsening pregnancy symptoms, side effects of medications, perceived risks, mental health symptoms, poor social support, and socioeconomic status. Recommendations that evolved from the studies to improve adherence included education, counselling, improved support networks, and social interventions, while the main reported interventional study employed continuous education on the impact of adherence on perinatal outcomes.
Medication nonadherence in gestational diabetes seems to be influenced by multiple factors with some educational interventions positively impacting adherence behaviours. Thus, future research in women with gestational diabetes could consider interventions from a multifactorial perspective to improve therapeutic outcomes.
妊娠期糖尿病患者遵医嘱服药的情况与围产期结局密切相关。
从生物学和心理社会角度总结妊娠期糖尿病患者药物治疗依从性的现有信息，包括其流行情况和影响因素。
通过在 PubMed/MEDLINE、CINAHL、Scopus 和开放获取期刊目录中检索妊娠期糖尿病患者药物治疗依从性相关文献，采用阿克塞尔和奥马利的综述框架对证据进行探索和总结。
共检索到 2395 篇研究，其中 13 篇完全符合纳入标准。这些研究分别来自津巴布韦（5 篇）、伊朗（1 篇）、墨西哥（1 篇）、印度南部（1 篇）、美国（4 篇），以及一项涵盖澳大利亚、欧洲、北美和南美多国的多国研究。主要使用的抗糖尿病药物类型包括胰岛素（6 篇）、二甲双胍（4 篇）和格列本脲（2 篇）。药物治疗依从性的发生率为 35.6%至 97%，评估工具为自我报告量表（8 篇）。与不依从相关的主要因素包括妊娠症状恶化、药物副作用、感知风险、心理健康症状、社会支持差和社会经济地位低。从研究中提出的改善依从性的建议包括教育、咨询、改善支持网络和社会干预，而主要报道的干预性研究则对依从性对围产期结局的影响进行了持续教育。
妊娠期糖尿病患者的药物治疗依从性似乎受到多种因素的影响，一些教育干预措施对改善依从性行为有积极影响。因此，未来对妊娠期糖尿病患者的研究可以从多因素角度考虑干预措施，以改善治疗效果。
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