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使用自我报告的药物依从性原因量表,分析美国三年内 2 型糖尿病药物使用者自我报告的不依从趋势。

Trends of self-reported non-adherence among type 2 diabetes medication users in the United States across three years using the self-reported Medication Adherence Reasons Scale.

机构信息

Touro College of Pharmacy, 230 West 125th Street, New York, NY 10027, USA.

Kantar Health, 51 Valley Stream Pkwy, Malvern, PA 19355, USA.

出版信息

Nutr Metab Cardiovasc Dis. 2022 Jan;32(1):151-159. doi: 10.1016/j.numecd.2021.09.018. Epub 2021 Sep 24.

Abstract

BACKGROUND & AIMS: To determine the trends of self-reported non-adherence rates among adults taking Type 2 medicines (T2D) medicines between 2017 and 2019 and to identify the patterns for the frequently reported reasons for non-adherence in the United States.

METHODS & RESULTS: Data from the National Health and Wellness Survey, a self-administered, internet-based cross-sectional survey of US adults from 2017 to 2019 was used. Non-adherence was measured using the self-reported Medication Adherence Reasons Scale (MAR-Scale). Frequencies were used to identify the reasons for non-adherence for insulin and non-insulin therapies for T2D. Data were obtained from 2983 respondents in 2017, 5416 in 2018, and 5268 in 2019. Based on the MAR-Scale, the self-reported medication non-adherence rate was 25% in 2017, 21% in 2018, and 27% in 2019. The most common reason for non-adherence across all the three years was simple forgetfulness, yet patients reported the lowest mean number of days missing medication for that reason. Though less frequently reported, non-adherence lasted longer when patient did not know how to take their medicines, cost was a reason, or had concerns about the long term effects of the medicines.

CONCLUSIONS

With no significant improvement in adherence with T2D medicines over time, regardless of better awareness and extensive diabetes education, focus should be on individualized non-adherence reasons-based interventions.

摘要

背景与目的

本研究旨在确定 2017 年至 2019 年期间,美国成年人报告的 2 型糖尿病(T2D)药物治疗不依从率的趋势,并确定美国常见不依从原因的模式。

方法与结果

本研究使用了 2017 年至 2019 年期间一项针对美国成年人的基于互联网的自我管理的全国健康和健康调查(National Health and Wellness Survey)的数据。采用自我报告的用药依从性原因量表(Medication Adherence Reasons Scale,MAR-Scale)来衡量不依从性。使用频率来确定胰岛素和非胰岛素治疗 T2D 的不依从原因。2017 年、2018 年和 2019 年分别从 2983 名、5416 名和 5268 名受访者中获得数据。根据 MAR-Scale,2017 年、2018 年和 2019 年的自我报告药物不依从率分别为 25%、21%和 27%。所有三年中最常见的不依从原因是简单的健忘,但患者报告因该原因漏服药物的平均天数最少。尽管报告频率较低,但当患者不知道如何服用药物、药物费用是一个原因或对药物的长期影响存在担忧时,不依从的时间会更长。

结论

尽管随着时间的推移,无论对糖尿病的认识和广泛的糖尿病教育如何提高,T2D 药物的依从性都没有显著改善,应关注基于个体化不依从原因的干预措施。

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