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《保加利亚真实世界试点研究:糖尿病患者的药物依从性及其相关因素》。

Medication Adherence among Patients with Diabetes Mellitus and Its Related Factors-A Real-World Pilot Study in Bulgaria.

机构信息

Department of Organization and Economics of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria.

Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria.

出版信息

Medicina (Kaunas). 2023 Jun 26;59(7):1205. doi: 10.3390/medicina59071205.

Abstract

: The objective is to evaluate medication adherence level (MA) and the relevant determinants of MA among patients with type 2 diabetes mellitus (T2DM) monitored in ambulatory settings by general practitioners. : A cross-sectional study was conducted among patients with T2DM monitored in a GP practice in Sofia, Bulgaria (September-December 2022). All patients were interviewed according to a predesigned questionnaire after granting informed consent. MA level was evaluated through the Morisky-Green four-item questionnaire, and health-related quality of life was evaluated by EQ-5D-5L and VAS (visual analogue scale). Data were aggregated and statistically evaluated. : The total number of observed patients was 93. Around 48.4% of patients were female, and 90.3% of patients were between 50 and 80 years of age. Multimorbidity was identified among 70% ( = 65) of the respondents. High and medium levels of MA were revealed in 64.51% and 33.3% of respondents, respectively. Patients treated with insulin secretagogues were most adherent to the therapy ( = 83.3%) in comparison with the other treatment groups. The onset of the disease, professional status, age, gender, number of therapies, and quality of life did not affect the level of MA ( > 0.05). VAS scores among nonsmokers (VAS = 63.16 ± 20.45 vs. 72.77 ± 14.3) and non-consumers of alcohol (VAS = 63.91 ± 19.34 vs. VAS = 72.54 ± 15.98) were statistically significant lower ( < 0.05). A significant related factor for MA was years lived with diabetes (OR = 3.039, 95% CI 1.1436-8.0759, = 0.0258). The longer the disease duration, the more the odds for a high MA level increased. : The number of nonadherent diabetic patients in Bulgaria is low, which might be evidence of patients' concern about their own health and understanding about the importance of prescribed therapy. Further comprehensive study with additional patients is required to confirm the results and investigate the predicting factors for a high level of MA.

摘要

: 目的是评估在普通科医生门诊监测的 2 型糖尿病(T2DM)患者的药物依从性(MA)水平及其相关决定因素。: 这是一项在保加利亚索非亚的一家全科医生诊所进行的横断面研究(2022 年 9 月至 12 月)。所有患者在知情同意后,根据预先设计的问卷进行访谈。通过 Morisky-Green 四项问卷评估 MA 水平,通过 EQ-5D-5L 和 VAS(视觉模拟量表)评估健康相关生活质量。对数据进行汇总和统计评估。: 共观察到 93 名患者。约 48.4%的患者为女性,90.3%的患者年龄在 50 至 80 岁之间。70%(=65)的受访者被诊断为合并症。高和中 MA 水平分别在 64.51%和 33.3%的受访者中得到揭示。与其他治疗组相比,接受胰岛素促分泌剂治疗的患者对治疗的依从性最高(=83.3%)。疾病的起始、职业状况、年龄、性别、治疗方法的数量和生活质量对 MA 水平没有影响(>0.05)。不吸烟(VAS=63.16±20.45 与 VAS=72.77±14.3)和不饮酒(VAS=63.91±19.34 与 VAS=72.54±15.98)的患者的 VAS 评分存在统计学显著差异(<0.05)。MA 的一个显著相关因素是糖尿病患者的患病年限(OR=3.039,95%CI 1.1436-8.0759,=0.0258)。患病时间越长,MA 水平越高的可能性就越大。: 在保加利亚,不依从糖尿病患者的数量较少,这可能表明患者对自身健康的关注以及对所开疗法重要性的认识。需要进一步进行综合研究,以确认结果并调查高水平 MA 的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fe2/10383103/7301da5591a1/medicina-59-01205-g001.jpg

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