Medication adherence and associated hemoglobin A1c in type 2 diabetes
Medication adherence and associated hemoglobin A1c in type 2 diabetes
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DOI：
10.1345/aph.1d612
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发表时间：
2004-09-01
影响因子：
2.9
通讯作者：
Lubowski, TJ
中科院分区：
文献类型：
--
作者：
Krapek, K;King, K;Lubowski, TJ
背景：严格的血糖控制与糖尿病并发症的减少有关。坚持服用降糖药是控制血糖的关键。目的：评估稳定用药方案的2型糖尿病患者良好的血糖控制[糖化血红蛋白（HbA(1c)）水平]与遵医嘱治疗之间的关系。方法：Morisky调查是一份预测患者服药行为的4项问卷，用于评估301例患者的依从性。评估HbA（1c）与Morisky评分的关系，控制与患者人口统计学和临床特征相关的其他变量。数据分析采用log （HbA(1c)）的一般线性模型。结果：Morisky评分为0或1、2、3和4的患者未调整的平均HbA（1c）值（上限为14.0%）分别为8.92%、8.67%、7.74%和7.60%。在所有患者中，分别有13.0%、14.0%、24.3%和48.8%的患者得分为0或1、2、3和4分。良好的依从性（Morisky评分大于或等于3）与总HbA（1c）降低10% （p = 0.0003）相关，该模型调整了所有其他因素。糖尿病病程（5-10年）和糖尿病并发症的存在也与HbA（1c）显著相关（p分别= 0.026和0.002）。27%的患者依从性差。结论：本研究发现，Morisky评分较高的患者的相关HbA（1c）测量值较低。莫里斯基评分可能是一种有效的工具，用于识别不良服药行为的患者，然后可以针对他们进行定向依从性咨询服务。
BACKGROUND: Tight blood glucose control has been correlated with a reduction in diabetes complications. Adherence to antidiabetic g medications is crucial to achieving blood glucose control.OBJECTIVE: To assess the relationship between good glucose control [glycosylated hemoglobin (HbA(1c)) levels] and adherence to prescribed treatment in patients on a stable medication regimen for type 2 diabetes.METHODS: The Morisky survey, a 4-item questionnaire that predicts patient medication-taking behavior, was used to assess adherence in 301 patients. The relationship of HbA(1c) to Morisky score was evaluated, controlling for other variables related to patient demographics and clinical characteristics. Data were analyzed using a general linear model on log (HbA(1c)).RESULTS: Unadjusted mean HbA(1c) values (capped at 14.0%) for patients with Morisky scores of 0 or 1, 2, 3, and 4 were 8.92%, 8.67%, 7.74%, and 7.60%, respectively. Of all patients, 13.0%, 14.0%, 24.3%, and 48.8% had scores of 0 or 1, 2, 3, and 4, respectively. Good adherence (Morisky score greater than or equal to3) was associated with a 10% lower total HbA(1c) (p = 0.0003) adjusted for all other factors in the model. Duration of diabetes (5-10 y) and presence of diabetes complications were also significantly associated with HbA(1c) (p = 0.026 and 0.002, respectively). Adherence was poor in 27% of patients.CONCLUSIONS: This study found that patients with a higher score on the Morisky scale had a lower associated HbA(1c) measurement. The Morisky score may be an efficient tool for identifying patients with poor medication-taking behavior who can then be targeted for directed adherence counseling services.