轻度认知障碍和糖尿病黑人个体中不一致的用药观念
Discordant Medication Beliefs in Black Individuals With Mild Cognitive Impairment and Diabetes.
作者信息
Rovner Barry W, Casten Robin J
机构信息
Departments of Neurology (BWR), Psychiatry, and Ophthalmology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.
Department of Psychiatry and Human Behavior (RJC), Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.
出版信息
Am J Geriatr Psychiatry. 2025 Apr;33(4):337-341. doi: 10.1016/j.jagp.2024.12.001. Epub 2024 Dec 10.
OBJECTIVE
To investigate the effects of discordant medication beliefs on diabetes self-management and glycemic control in older Black individuals with diabetes and Mild Cognitive Impairment (MCI).
METHODS
Cross-sectional analysis of baseline data from two clinical trials testing behavioral interventions to improve glycemic control in older Black primary care patients with diabetes and MCI.
RESULTS
The mean number of discordant medication beliefs was 6 (SD = 3; range 0 to 16). Sixty-seven of 246 (27%) participants held ≥ 9 discordant beliefs (i.e., one SD above the mean), and these participants had worse diabetes self-management and glycemic control than participants with fewer beliefs.
CONCLUSIONS
Discordant medication beliefs, low adherence to diabetes self-management, poor glycemic control, and impaired cognition may exist in a causal relationship. Modifying discordant medication beliefs may eliminate the first step of this pathogenic sequence and reduce risk of cognitive decline in a high-risk population of older Black individuals with diabetes.
目的
探讨不一致的用药观念对患有糖尿病和轻度认知障碍（MCI）的老年黑人糖尿病患者自我管理及血糖控制的影响。
方法
对两项临床试验的基线数据进行横断面分析，这两项试验旨在测试行为干预措施对患有糖尿病和MCI的老年黑人初级护理患者血糖控制的改善效果。
结果
不一致用药观念的平均数量为6（标准差 = 3；范围为0至16）。246名参与者中有67名（27%）持有≥9种不一致观念（即高于平均值一个标准差），与观念较少的参与者相比，这些参与者的糖尿病自我管理及血糖控制情况更差。
结论
不一致的用药观念、对糖尿病自我管理的低依从性、较差的血糖控制及认知障碍可能存在因果关系。改变不一致的用药观念可能消除这一致病序列的第一步，并降低患有糖尿病的高危老年黑人人群认知衰退的风险。
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