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基于风险感知态度框架的妊娠期糖尿病合并产后糖代谢紊乱患者用药依从性研究

Study on medication adherence in patients with gestational diabetes mellitus complicated by postpartum glucose metabolism disorders based on the risk perception attitude framework.

作者信息

Zhou Bing, Zhou Zhuolin, Sun Yu, He Ting, Ge Weihong, Sun Lingjun, Ji Cheng

机构信息

Department of Pharmacy, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China.

Department of Pharmacy, China Pharmaceutical University Nanjing Drum Tower Hospital, Nanjing, China.

出版信息

Front Endocrinol (Lausanne). 2025 May 15;16:1501541. doi: 10.3389/fendo.2025.1501541. eCollection 2025.

Abstract

OBJECTIVE

This study aims to assess the compliance with anti-hypoglycemic drugs among postpartum patients with gestational diabetes mellitus (GDM) through a questionnaire survey, and to examine the factors that may influence this adherence. The goal is to enhance pharmacists' medication practices and improve glycemic control.

METHOD

Based on the theory of risk perception attitude framework, the study selected pregnant women who delivered at Nanjing DrumTower Hospital's obstetrics department from 2020 to 2022 and were diagnosed with GDM as the research subjects. The Morisky Medication Adherence Scale was used to evaluate their medication adherence. The correlation matrix was used to express whether there is a correlation between risk perception, self-efficacy, and medication adherence. Finally, a linear hierarchical regression model was used to present the moderating effect of self-efficacy on the relationship between risk perception and medication adherence.

RESULTS

A total of 80 postpartum GDM patients receiving medication intervention were included in the study to assess medication adherence. The median score on the MMAS-8 scale was 3.75 (3.50, 5.50). The results of the Spearman test showed a positive correlation between GDM patients' perception of future diabetes risk and postpartum medication adherence (r= 0.778, P<0.001). Additionally, self-efficacy was also positively correlated with medication adherence (r= 0.631, P<0.001). The results of the linear stratified regression model indicated that self-efficacy moderates the relationship between risk perception and medication adherence.

CONCLUSION

The results of the MMAS-8 scale survey indicate poor medication adherence among postpartum GDM patients, with a significantly lower rate of good medication adherence compared to general T2DM patients. The stratified regression analysis demonstrates that risk perception and self-efficacy jointly influence postpartum medication adherence, and the risk perception attitude model can predict medication adherence among GDM patients postpartum.

摘要

目的

本研究旨在通过问卷调查评估产后妊娠期糖尿病(GDM)患者对降糖药物的依从性,并探讨可能影响这种依从性的因素。目标是加强药师的用药指导并改善血糖控制。

方法

基于风险感知态度框架理论,本研究选取2020年至2022年在南京鼓楼医院产科分娩且被诊断为GDM的孕妇作为研究对象。采用Morisky药物依从性量表评估其用药依从性。使用相关矩阵来表示风险感知、自我效能感与用药依从性之间是否存在相关性。最后,采用线性分层回归模型呈现自我效能感对风险感知与用药依从性之间关系的调节作用。

结果

本研究共纳入80例接受药物干预的产后GDM患者以评估用药依从性。MMAS-8量表的中位数得分为3.75(3.50,5.50)。Spearman检验结果显示,GDM患者对未来糖尿病风险的感知与产后用药依从性呈正相关(r = 0.778,P < 0.001)。此外,自我效能感与用药依从性也呈正相关(r = 0.631,P < 0.001)。线性分层回归模型结果表明,自我效能感调节了风险感知与用药依从性之间的关系。

结论

MMAS-8量表调查结果表明,产后GDM患者的用药依从性较差,与一般2型糖尿病患者相比,良好用药依从率显著更低。分层回归分析表明,风险感知和自我效能感共同影响产后用药依从性,且风险感知态度模型可预测产后GDM患者的用药依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58aa/12119265/79f9c6092409/fendo-16-1501541-g001.jpg

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