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首页> 外文期刊>BMJ Open Diabetes Research & Care >Research: Medication regimen complexity and its impact on medication adherence and glycemic control among patients with type 2 diabetes mellitus in an Ethiopian general hospital
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Research: Medication regimen complexity and its impact on medication adherence and glycemic control among patients with type 2 diabetes mellitus in an Ethiopian general hospital

机译：研究：埃塞俄比亚综合医院2型糖尿病患者的用药方案复杂性及其对药物依从性和血糖控制的影响

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Background Different studies reported that higher diabetes-specific Medication Regimen Complexity Index (MRCI) has a negative impact on glycemic control potentially by decreasing medication adherence. However, information about regimen complexity and its association with adherence and glycemic control in Ethiopian patients with diabetes is unknown.Aim To evaluate medication regimen complexity and to assess its impact on medication adherence and glycemic control among patients with type 2 diabetes Mellitus (T2DM).Methods A hospital-based cross-sectional design was conducted at Debre Tabor General Hospital from 1 May 2018 to 30 June 2018. Medication regimen complexity was evaluated using the 65-item validated tool called Medication Complexity Index (MRCI). Adherence was measured using Morisky Medication Adherence Scale while patients were classified as having poor or good glycemic control based on the recent record of their fasting blood glucose. Multivariable logistic regression analysis was applied to determine the association between predictive variables and outcome variables.Results A total of 275 patients with T2DM who meet the inclusion criteria were included in the final analysis. About 22.2% of the participants were classified as having high diabetes-specific MRCI, whereas 35.6% of the participants were classified as having high patient-level MRCI. The majority (70.5%) of the respondents were adherent to their medications, and 42.9% of the total population were categorized as having good glycemic control. According to the result of the multivariate analysis, patients with low-level and moderate-level MRCI of both diabetes-specific and patient-level MRCI were more adherent to their medication compared with patients with high MRCI. High diabetes medication regimen complexity was associated with poor glycemic control in the adjusted analyses (adjusted OR = 0.276; 95%?CI = 0.100 o 0.759).Conclusion The prevalence of high MRCImedication regimen complexity index is high among patients with T2DM. Patients with low and moderate regimen complexity had improved adherence. High diabetes-specific medication regimen complexity was associated with poor glycemic control. Simplification of a complex medication regimen for patients with diabetes should be sought by physicians and pharmacists to improve medication adherence and subsequent improvement in glycemic control.
机译：背景不同的研究报道，较高的糖尿病特异性药物治疗复杂度指数（MRCI）可能通过降低药物依从性而对血糖控制产生负面影响。然而，关于埃塞俄比亚糖尿病患者的治疗方案复杂性及其与依从性和血糖控制的相关性的信息尚不清楚。目的是评估2型糖尿病（T2DM）患者的药物治疗方案复杂性并评估其对药物依从性和血糖控制的影响。方法于2018年5月1日至2018年6月30日在德布雷塔博尔总医院进行了基于医院的横断面设计。使用经过验证的65个项目的药物复杂性指数（MRCI）评估药物治疗方案的复杂性。使用Morisky药物依从性量表测量依从性，同时根据近期空腹血糖的记录将患者归为血糖控制不良或良好。结果采用多变量logistic回归分析确定预测变量和结果变量之间的关联。结果最终纳入纳入纳入标准的275例T2DM患者。约22.2％的参与者被归类为高糖尿病特异性MRCI，而35.6％的参与者被归类为具有高患者水平的MRCI。大部分受访者（70.5％）坚持服药，总人群中有42.9％被归类为血糖控制良好。根据多变量分析的结果，与高MRCI的患者相比，糖尿病特异性和患者MRCI的低和中度MRCI患者对药物的依从性更高。在校正后的分析中，较高的糖尿病药物治疗方案复杂性与不良的血糖控制相关（校正后OR = 0.276; 95％？CI = 0.100 o 0.759）。结论T2DM患者中较高的MRCI药物治疗方案复杂性指数普遍存在。方案复杂度较低和中等的患者依从性得到改善。高糖尿病特异性药物治疗方案的复杂性与不良的血糖控制有关。医师和药剂师应寻求简化糖尿病患者的复杂用药方案，以改善用药依从性并随后改善血糖控制。

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