Adherence to therapies in patients with type 2 diabetes.
Adherence to therapies in patients with type 2 diabetes.
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DOI：
10.1007/s13300-013-0034-y
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发表时间：
2013-12
期刊：
影响因子：
3.8
通讯作者：
Orozco-Beltran, Domingo
中科院分区：
文献类型：
--
作者：
Garcia-Perez, Luis-Emilio;Alvarez, Maria;Dilla, Tatiana;Gil-Guillen, Vicente;Orozco-Beltran, Domingo
坚持治疗被定义为一个人在服用药物，遵循饮食和/或执行生活方式改变的行为与医疗保健提供者同意的建议相对应的程度。最初鼓励2型糖尿病患者保持健康的饮食和运动方案，随后进行早期药物治疗，通常包括一种或多种口服降糖药，随后可能包括注射治疗。为了预防与2型糖尿病相关的并发症，治疗通常还包括用于控制血压、血脂异常和其他疾病的药物，因为患者通常患有三种或四种以上的慢性疾病。尽管有治疗的益处，但研究表明，不到50%的患者达到了推荐的血糖目标，这可能与治疗依从性降低有关。因此，高血糖症和长期并发症增加了发病率和过早死亡率，并导致保健服务费用增加。不依从的原因是多方面的，难以确定。这些因素包括年龄、信息、疾病的感知和持续时间、给药方案的复杂性、多药治疗、心理因素、安全性、耐受性和成本。各种措施，以提高患者的满意度和增加2型糖尿病的依从性进行了研究。这些措施包括通过固定剂量的复方药丸和较低频率的给药方案降低治疗的复杂性，使用与较少不良事件（低血糖或体重增加）相关的药物，改善患者与医疗保健提供者沟通的教育计划，提醒系统和社会支持以帮助降低成本。在当前的叙述性综述中，讨论了影响2型糖尿病不同治疗依从性的因素，沿着依从性差的结局，不依从的经济影响，以及旨在提高依从性的策略。
Adherence to therapy is defined as the extent to which a person’s behavior in taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a healthcare provider. Patients presenting with type 2 diabetes mellitus are initially encouraged to maintain a healthy diet and exercise regimen, followed by early medication that generally includes one or more oral hypoglycemic agents and later may include an injectable treatment. To prevent the complications associated with type 2 diabetes, therapy frequently also includes medications for control of blood pressure, dyslipidemia and other disorders, since patients often have more than three or four chronic conditions. Despite the benefits of therapy, studies have indicated that recommended glycemic goals are achieved by less than 50% of patients, which may be associated with decreased adherence to therapies. As a result, hyperglycemia and long-term complications increase morbidity and premature mortality, and lead to increased costs to health services. Reasons for nonadherence are multifactorial and difficult to identify. They include age, information, perception and duration of disease, complexity of dosing regimen, polytherapy, psychological factors, safety, tolerability and cost. Various measures to increase patient satisfaction and increase adherence in type 2 diabetes have been investigated. These include reducing the complexity of therapy by fixed-dose combination pills and less frequent dosing regimens, using medications that are associated with fewer adverse events (hypoglycemia or weight gain), educational initiatives with improved patient–healthcare provider communication, reminder systems and social support to help reduce costs. In the current narrative review, factors that influence adherence to different therapies for type 2 diabetes are discussed, along with outcomes of poor adherence, the economic impact of nonadherence, and strategies aimed at improving adherence.
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影响因子：
16.2
作者：
American Diabetes Association
通讯作者：
American Diabetes Association
影响因子：
16.2
作者：
Brandle, M;Zhou, HH;Herman, WH
通讯作者：
Herman, WH
影响因子：
--
作者：
Bramley, TJ;Gerbino, PP;Frech-Tamas, F
通讯作者：
Frech-Tamas, F
影响因子：
2.4
作者：
Breitscheidel, L;Stamenitis, S;Schoffski, O
通讯作者：
Schoffski, O
影响因子：
4.5
作者：
Cramer, Joyce A.;Roy, Anuja;Wong, Peter K.
通讯作者：
Wong, Peter K.