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2型糖尿病患者中与障碍及药物依从性相关的因素:一项横断面研究

Factors related to barriers and medication adherence in patients with type 2 diabetes mellitus: a cross-sectional study.

作者信息

Zairina Elida, Nugraheni Gesnita, Sulistyarini Arie, Setiawan Catur Dian, Kripalani Sunil, Lestari Safira Indah

机构信息

Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Jl. Dr Ir Haji Soekarno, Mulyorejo, Surabaya, 60115 Indonesia.

Innovative Pharmacy Practice and Integrated Outcome Research (INACORE) Group, Universitas Airlangga, Surabaya, Indonesia.

出版信息

J Diabetes Metab Disord. 2022 Jan 29;21(1):219-228. doi: 10.1007/s40200-021-00961-6. eCollection 2022 Jun.

Abstract

PURPOSE

Evidence has shown that 50% of patients, including type 2 diabetes mellitus (DM), are non-adherent to the prescribed antidiabetic medication regimen. Some barriers lead to nonadherence in people with DM type 2. The study aimed to identify factors related to adherence in patient with DM and to assess the correlation between barriers to adherence type 2 DM patients.

METHODS

The cross-sectional study was conducted in 63 primary healthcare centers in Surabaya, Indonesia. Patients with DM type 2 were recruited between April and September 2019 using convenient sampling technique. Ethics approval was obtained (80/EA/KEPK/2019).

RESULTS

A total of 266 patients with type 2 DM participated in this study. Of the respondents, 201 (75.2%) were female. Unwanted drug effects, changes in medication regimens, and refilling the prescription when the drugs run out were most reported factors that affected adherence. Spearman correlations and linear regression tests were used to examine the relationship between barriers to medication adherence, and education with medication adherence. A significant difference was observed between the level of education and adherence (p = 0.031). The results showed an association between barriers to medication and adherence to medication (r = 0.304; p < 0.001) which was confirmed in regression analysis (R = 0.309, R square = 0.095, p <0.001).

CONCLUSIONS

Barriers to adherence are common and affect adherence to therapy. It is essential to expand the roles of health care professionals in the community to include counseling, barrier-monitoring, education, and problem-solving to improve patient medication adherence.

摘要

目的

有证据表明,包括2型糖尿病(DM)患者在内,50%的患者不遵守规定的抗糖尿病药物治疗方案。一些障碍导致2型糖尿病患者不坚持治疗。本研究旨在确定与糖尿病患者坚持治疗相关的因素,并评估2型糖尿病患者坚持治疗的障碍之间的相关性。

方法

这项横断面研究在印度尼西亚泗水的63个初级医疗保健中心进行。2019年4月至9月期间,采用方便抽样技术招募了2型糖尿病患者。获得了伦理批准(80/EA/KEPK/2019)。

结果

共有266例2型糖尿病患者参与了本研究。在受访者中,201例(75.2%)为女性。最常报告的影响坚持治疗的因素是药物不良反应、治疗方案的改变以及药物用完时重新开处方。使用Spearman相关性和线性回归测试来检验药物坚持治疗障碍与教育程度和药物坚持治疗之间的关系。观察到教育程度与坚持治疗之间存在显著差异(p = 0.031)。结果显示药物障碍与药物坚持治疗之间存在关联(r = 0.304;p < 0.001),这在回归分析中得到了证实(R = 0.309,R平方 = 0.095,p <0.001)。

结论

坚持治疗的障碍很常见,会影响治疗的坚持性。扩大社区医疗保健专业人员的作用,包括咨询、障碍监测、教育和解决问题,以提高患者的药物治疗依从性至关重要。

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