Jaya Ajan Maheswaran, Harries Anthony D, Rahman Anisur, Khogali Mohammed, Chinnakali Palanivel, Gopal Bipin
Directorate of Health Services, Kerala, Thiruvananthapuram 695101, India.
Centre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), 75001 Paris, France.
Trop Med Infect Dis. 2022 Jun 14;7(6):104. doi: 10.3390/tropicalmed7060104.
Compliance with medication in persons with diabetes mellitus (DM) has been a challenge during the COVID-19 pandemic, leading to poor glycemic control and higher risk of complications. In the state of Kerala, India, 20−25% of adults have DM. Our cross-sectional study aimed to assess medication compliance and factors associated with poor compliance in DM persons attending selected primary care government facilities in Kerala during the COVID-19 pandemic. Persons registered with DM for >6 months were consecutively interviewed between August and September 2021. Poor compliance was defined as answering “No” to one or more of three questions related to access and intake of medication two weeks prior to and the day before the interview. Factors independently associated with poor compliance were assessed using adjusted prevalence ratios (aPr) and 95% confidence intervals. Of the 560 DM persons included, 209 (37%) exhibited poor compliance. Factors associated with poor compliance were age 19−45 years (aPr 1.4, 1.1−1.9); inability to be blood glucose tested during the COVID-19 pandemic (aPr 3.6, 2.9−4.3); not having COVID-19 (aPr 1.4, 1.0−1.9); and being double vaccinated against COVID-19 (aPr 1.4, 1.1−2.0). Focused attention must be paid to these groups to improve medication compliance and prevent DM complications and severe COVID-19-related disease.
在2019冠状病毒病大流行期间,糖尿病患者的药物依从性一直是一项挑战,导致血糖控制不佳和并发症风险更高。在印度喀拉拉邦,20%至25%的成年人患有糖尿病。我们的横断面研究旨在评估2019冠状病毒病大流行期间在喀拉拉邦选定的初级保健政府机构就诊的糖尿病患者的药物依从性以及与依从性差相关的因素。2021年8月至9月期间,对登记患有糖尿病超过6个月的患者进行了连续访谈。依从性差被定义为在访谈前两周及访谈前一天,对与药物获取和服用相关的三个问题中的一个或多个回答“否”。使用调整后的患病率比(aPr)和95%置信区间评估与依从性差独立相关的因素。在纳入的560名糖尿病患者中,209名(37%)表现出依从性差。与依从性差相关的因素包括年龄在19至45岁之间(aPr 1.4,1.1至1.9);在2019冠状病毒病大流行期间无法进行血糖检测(aPr 3.6,2.9至4.3);未感染2019冠状病毒病(aPr 1.4,1.0至1.9);以及接种了两剂2019冠状病毒病疫苗(aPr 1.4,1.1至2.0)。必须对这些群体给予重点关注,以提高药物依从性,预防糖尿病并发症和严重的2019冠状病毒病相关疾病。