Medication beliefs, treatment complexity, and non-adherence to different drug classes in patients with type 2 diabetes
Medication beliefs, treatment complexity, and non-adherence to different drug classes in patients with type 2 diabetes
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DOI：
10.1016/j.jpsychores.2013.11.003
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发表时间：
2014-02-01
影响因子：
4.7
通讯作者：
Denig, Petra
中科院分区：
文献类型：
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作者：
de Vries, Sieta T.;Keers, Joost C.;Denig, Petra
目的：评估2型糖尿病患者常用的三个治疗组的患者用药信念和治疗复杂性与无意和有意不依从的关系。方法：将依从性调查数据（药物依从性报告量表）和药物信念（药物信念问卷）与格罗宁根倡议的处方数据结合起来分析2型糖尿病治疗（GIANIT）数据库。每个治疗组（降血糖、降血压和降脂药物）将患者分为依从性、主要是无意的非依从性或部分有意的非依从性。使用药物治疗方案复杂性指数来衡量治疗复杂性，其中包括剂型、给药频率和服用药物的其他说明。采用Kruskal-Wallis和Mann-Whitney U检验进行分析。结果：在257名接触过的患者中，133名（52％）返回了问卷，患者平均年龄为66岁，其中50％为女性。遵守者之间的必然性信念没有显着差异，主要是无意识的不遵守者和部分有意的不遵守者（在 5 到 25 的范围内，差异小于 5 分）。对于降血压药物，报告故意不遵守的患者比遵守者有更高的担忧信念（8分差异，P = 0.01）。依从者的治疗复杂性得分较低，但主要是无意和部分有意不依从降糖药和降血压药物的人的治疗复杂性得分相似。结论：治疗复杂性总体上与不依从性有关。对必要性的信念与不依从性没有很强的相关性，而患者的担忧信念可能与故意不依从性相关。然而，这些决定因素的作用因治疗组而异。 (C) 2013 Elsevier Inc. 保留所有权利。
Objective: To assess the relationship of patients' medication beliefs and treatment complexity with unintentional and intentional non-adherence for three therapeutic groups commonly used by patients with type 2 diabetes.Methods: Survey data about adherence (Medication Adherence Report Scale) and beliefs about medicines (Beliefs about Medicines Questionnaire) were combined with prescription data from the Groningen Initiative to ANalyse Type 2 diabetes Treatment (GIANIT) database. Patients were classified as being adherent, mainly unintentional non-adherent, or partly intentional non-adherent per therapeutic group (glucose-, blood pressure-, and lipid-lowering drugs). Treatment complexity was measured using the Medication Regimen Complexity Index, which includes the dosage form, dosing frequency and additional directions of taking the drug. Analyses Were performed using Kruskal-Wallis and Mann-Whitney U-tests.Results: Of 257 contacted patients, 133(52%) returned the questionnaire, The patients had a mean age of 66 years and 50% were females. Necessity beliefs were not significantly different between the adherers, mainly unintentional non-adherers, and partly intentional non-adherers (differences smaller than 5 points on a scale from 5 to 25). For blood pressure-lowering drugs, patients reporting intentional non-adherence had higher concern beliefs than adherers (8 point difference, P = 0.01). Treatment complexity scores were lower for adherers but similar for mainly unintentional and partly intentional non-adherers to glucose- and blood pressure-lowering drugs.Conclusion: Treatment complexity was related to non-adherence in general. Beliefs about necessity were not strongly associated with non-adherence, while patients' concern beliefs may be associated with intentional non-adherence. However, the role of these determinants differs per therapeutic group. (C) 2013 Elsevier Inc. All rights reserved.