Li Haiyan, Min Hui, Zhang Lu, Li Youjia, Wang Jing, Jia Xiaoni
Department of Pharmacy, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China.
Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Pharmacol. 2025 Jun 26;16:1634768. doi: 10.3389/fphar.2025.1634768. eCollection 2025.
Social support may be important in the management of type 2 diabetes. This study aimed to investigate the relationships between social support, medication adherence, and glycemic control in Northwestern China.
A cross-sectional questionnaire-based survey was carried out in the department of endocrinology in three teaching hospitals between February 2023 and April 2025. The Social Support Rating Scale (SSRS) was used to assess social support. The Adherence to Refills and Medications Scale (ARMS) was used to assess adherence to antidiabetic medications. Logistic regression analyses were performed to identify the factors associated with medication nonadherence and poor glycemic control. Receiver operating characteristic (ROC) was used to assess the performance of the logistic regression model in predicting medication nonadherence.
A total of 522 inpatients finished the questionnaires, 323 (61.9%) inpatients were nonadherent to antidiabetic medications and the prevalence rate of poor glycemic control was estimated to be 82.6%. According to the multivariable logistic regression analysis, inpatients who had received low levels of social support had 2.48 times (95% CI = 1.419-4.322) greater odds of nonadherence to antidiabetic medications than those received high levels of social support, while inpatients who were underweight had 2.78 times (95% CI = 1.054-7.330) greater odds of nonadherence to antidiabetic medications than those with normal BMI. We found that comorbid with hyperlipidemia and combination of oral and injectable antidiabetic medications use were negatively associated with nonadherence to antidiabetic medications. Inpatients prescribed injectable antidiabetic medications were positive associated with poor glycemic control, while older inpatients and the presence of drug-related side effects were negative associated with poor glycemic control.
The relatively low adherence and poor glycemic control among inpatients with T2DM in northwestern China highlighted the urgent need for effective strategies to improve adult diabetes management. Pharmacists should play an important role in strengthening social support to improve adult diabetes self-management.
社会支持在2型糖尿病管理中可能很重要。本研究旨在调查中国西北地区社会支持、药物依从性和血糖控制之间的关系。
2023年2月至2025年4月期间，在三家教学医院的内分泌科进行了一项基于问卷调查的横断面研究。采用社会支持评定量表（SSRS）评估社会支持。采用药物续方和用药依从性量表（ARMS）评估抗糖尿病药物的依从性。进行逻辑回归分析以确定与药物不依从和血糖控制不佳相关的因素。采用受试者工作特征（ROC）曲线评估逻辑回归模型预测药物不依从的性能。
共有522名住院患者完成问卷调查，323名（61.9%）住院患者抗糖尿病药物治疗依从性差，血糖控制不佳的患病率估计为82.6%。根据多变量逻辑回归分析，社会支持水平低的住院患者抗糖尿病药物不依从的几率是社会支持水平高的患者的2.48倍（95%CI=1.419-4.322），而体重过轻的住院患者抗糖尿病药物不依从的几率是体重指数正常患者的2.78倍（95%CI=1.054-7.330）。我们发现，合并高脂血症以及联合使用口服和注射用抗糖尿病药物与抗糖尿病药物不依从呈负相关。使用注射用抗糖尿病药物的住院患者与血糖控制不佳呈正相关，而老年住院患者和药物相关副作用的存在与血糖控制不佳呈负相关。
中国西北地区2型糖尿病住院患者的依从性相对较低且血糖控制不佳，凸显了迫切需要有效策略来改善成人糖尿病管理。药剂师应在加强社会支持以改善成人糖尿病自我管理方面发挥重要作用。
