Adherence to prescribed oral hypoglycaemic medication in a population of patients with Type 2 diabetes: a retrospective cohort study
Adherence to prescribed oral hypoglycaemic medication in a population of patients with Type 2 diabetes: a retrospective cohort study
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DOI：
10.1046/j.1464-5491.2002.00689.x
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发表时间：
2002-04-01
影响因子：
3.5
通讯作者：
Morris, AD
中科院分区：
文献类型：
--
作者：
Donnan, PT;MacDonald, TM;Morris, AD
目的评价社区中接受单一口服降糖药治疗的所有2型糖尿病患者的依从性模式和预测因素。特别是，要测试的假设，每天一片与更好的遵守比一个以上。400 000）。受试者为1993年1月1日至1995年12月31日期间居住在Tayside的居民，口服降血糖药物处方至少12个月。主要的结果指标是磺脲类药物和二甲双胍的依从性指数，分别调整住院期间的处方。（大于或等于90%）在31%的单用磺脲类药物的患者中发现（n = 1329，中位依从性=每年300天），34%的二甲双胍单药处方患者（n = 528，中位依从性=每年302天）。有显着的线性趋势，每天服用片剂的数量增加（p = 0.001），并增加联合用药（p = 0.0001）磺脲类药物调整后，其他factor.Conclusions在社区只有三分之一的2型糖尿病有足够的遵守OHD。每天服用一片片剂比服用多片片剂具有更高的依从性。依从性差是2型糖尿病治疗中复杂药物方案获益的主要障碍。
Aims To evaluate the patterns and predictors of adherence in all patients with Type 2 diabetes in the community receiving treatment with a single oral hypo glycaemic drug. In particular, to test the hypothesis that one tablet per day is associated with better adherence than more than one.Methods The study design was a retrospective cohort study set in the Tayside region of Scotland (population approx. 400 000). Participants were residents of Tayside from 1 January 1993 until 31 December 1995 with at least 12 months of prescriptions of oral hypoglycaemic drugs (OHDs). The main outcome measures were adherence indices for sulphonylureas and metformin separately, adjusting for prescribing while hospitalized.Results Of the total 2920 subjects identified, adequate adherence (greater than or equal to 90%) was found in 31 % of those prescribed sulphonylureas alone (n = 1329, median adherence = 300 days per year), and in 34 % of those prescribed metformin alone (n = 528, median = 302 days per year). There were significant linear trends of poorer adherence with each increase in the daily number of tablets taken (p = 0.001) and increase in co-medication (p = 0.0001) for sulphonylureas alone after adjustment for other factors.Conclusions In the community only one in three with Type 2 diabetes had adequate adherence to OHDs. One tablet per day administration was associated with greater adherence than multiple tablets. Poor adherence is a major obstacle to the benefit of complex drug regimens in the treatment of Type 2 diabetes.