Chantzaras Athanasios, Yfantopoulos John
MBA Health Economics & Management School of Economics and Political Sciences, National and Kapodistrian University of Athens, 6 Themistokleous Street, 10678, Athens, Greece.
Hormones (Athens). 2025 Feb 20. doi: 10.1007/s42000-025-00631-9.
To investigate medication non-adherence and its determinants in diabetes, hypertension, and hyperlipidemia.
In a multicenter, cross-sectional, non-interventional study, 518 diabetic, 721 hypertensive, and 463 hyperlipidemic patients were recruited, using consecutive sampling, in Greece during the COVID-19 pandemic. Medication adherence was measured with the Adherence to Refills and Medications Scale (ARMS). Multiple linear regressions with robust standard errors investigated the predictors of the ARMS summary score.
Perfect adherence was estimated at 16%, 12%, and 11%, and low adherence at 38.8%, 61.3%, and 66.7% in diabetes, hypertension, and hyperlipidemia, respectively. The factors that significantly increased the likelihood of non-adherence were the following: (a) lower age, female gender, no public health insurance, high perceived threat of illness, low satisfaction with physician consultations, shorter consultations, bad general health, fewer comorbidities, and type 2 diabetes; (b) male gender, not being married, low education, no public insurance, smoking, frequent drinking, shorter consultations, self-perceived inadequacy of knowledge, negative views of medication, presence of comorbidities, fewer medicines being used, and high blood pressure in hypertension; and (c) lower age, not being employed, smoking, frequent drinking, no public insurance, low satisfaction with consultations, negative views of medication, taking 3-4 medicines, high LDL, and low HDL and triglyceride levels in hyperlipidemia. Different curvilinear associations of adherence with BMI and exercise were also found.
Medication non-adherence is very common in diabetes, hypertension, and hyperlipidemia. Strategies to improve adherence should consider the different determinants of non-adherence among patient groups.
调查糖尿病、高血压和高脂血症患者的用药依从性及其决定因素。
在新冠疫情期间于希腊开展一项多中心、横断面、非干预性研究，采用连续抽样法招募了518例糖尿病患者、721例高血压患者和463例高脂血症患者。使用药品续配与用药依从性量表（ARMS）测量用药依从性。采用稳健标准误的多元线性回归分析ARMS总分的预测因素。
糖尿病、高血压和高脂血症患者的完全依从率分别估计为16%、12%和11%，低依从率分别为38.8%、61.3%和66.7%。显著增加不依从可能性的因素如下：（a）年龄较小、女性、无公共医疗保险、对疾病的感知威胁较高、对医生咨询满意度较低、咨询时间较短、总体健康状况较差、合并症较少以及2型糖尿病；（b）男性、未婚、教育程度低、无公共保险、吸烟、频繁饮酒、咨询时间较短、自我感觉知识不足、对药物持负面看法、存在合并症、用药较少以及高血压；（c）年龄较小、未就业、吸烟、频繁饮酒、无公共保险、对咨询满意度较低、对药物持负面看法、服用3 - 4种药物、低密度脂蛋白较高、高密度脂蛋白和甘油三酯水平较低以及高脂血症。还发现了依从性与体重指数和运动之间不同的曲线关联。
用药不依从在糖尿病、高血压和高脂血症中非常普遍。提高依从性的策略应考虑不同患者群体中不依从的不同决定因素。
