Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
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DOI：
10.1111/jcpt.12360
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发表时间：
2016-06
影响因子：
2
通讯作者：
Kim JM
中科院分区：
文献类型：
--
作者：
Osborn CY;Mayberry LS;Kim JM
2型糖尿病（T2 DM）患者需要进行多种自我护理行为，以实现和维持最佳的血糖控制（HbA 1c），从而预防并发症和过早死亡。T2 DM和低社会经济地位（SES）患者更有可能出现次优HbA 1c，通常是由于与SES较高的患者相比，他们对推荐的自我护理活动的依从性较低。虽然研究支持进行某些糖尿病自我护理行为以优化血糖控制，但对每种行为的相对重要性的研究有限。确定哪些行为对低SES的T2 DM患者的HbA 1c最重要，对于为这一高危群体制定政策和干预措施特别有用。在一项对314名T2 DM和低SES成人的横断面研究中，我们使用糖尿病自我护理活动总结来评估自我护理行为，并使用多变量模型来测试哪些行为与较低的HbA 1c相关。在调整其他自我护理行为（β =-014，P = 0028）和进一步调整人口统计学和糖尿病特征（β =-016，P = 0024）后，只有药物依从性与较低的HbA 1c显著相关。药物依从性可能是T2 DM和低SES成人患者血糖控制的最重要自我护理行为。集中精力提高低SES患者人群的药物依从性可能会改善贫血控制。
Patients with type 2 diabetes mellitus (T2DM) are required to perform multiple self-care behaviours to achieve and maintain optimal glycaemic control (HbA1c), which prevents complications and premature mortality. Patients with T2DM and low socioeconomic status (SES) are more likely to have suboptimal HbA1c, often due to being less adherent to recommended self-care activities than their higher-SES counterparts. Although studies support performing certain diabetes self-care behaviours for optimizing glycaemic control, there is limited research on the relative importance of each behaviour for this purpose. Identifying what behaviours are most important for HbA1c among low-SES patients with T2DM would be particularly useful for informing policy and intervention efforts for this high-risk group. In a cross-sectional study of 314 adults with T2DM and low SES, we used the Summary of Diabetes Self-Care Activities to assess self-care behaviours and multivariate models to test which behaviours were associated with lower HbA1c. Only medication adherence was significantly associated with lower HbA1c after adjusting for the other self-care behaviours (β = −0 14, P = 0 028) and further adjusting for demographic and diabetes characteristics (β = −0 16, P = 0 024). Medication adherence may be the most important self-care behaviour for glycaemic control among adults with T2DM and low SES. Focused efforts to improve medication adherence among low-SES patient populations may improve glycaemic control.