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Concordance between two methods in measuring treatment adherence in patients with type 2 diabetes

机译：衡量2型糖尿病患者治疗依从性的两种方法之间的一致性

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Objective: We analyzed the concordance between two methods for measuring treatment adherence (TA) and studied the determinants of TA in patients with type 2 diabetes mellitus. Methods: We conducted a cross-sectional descriptive study in a primary care center, involving 320 diabetic patients. TA was measured using the Haynes–Sackett (H–S) adherence test during the patient interview and based on pharmacy refill data. TA was calculated globally and by drug groups (antihypertensive, lipid-lowering, and antidiabetic drugs). Results: Poor TA as measured by the H–S test was observed in 11.2% of the patients. Based on pharmacy refill data, there was a poor global TA rate of 30.3%, which was 33.3%, 26.6%, and 34.2% for oral antidiabetic, antihypertensive, and lipid-lowering drugs, respectively. Concordance between the two methods was poor. There was no relationship between the degree of disease control and TA as measured by the H–S test. Good TA measured based on pharmacy refill data for antidiabetic and antihypertensive drugs was associated with lower glycosylated hemoglobin and diastolic blood pressure values, respectively. Patients with good global TA showed lower glycosylated hemoglobin, diastolic blood pressure, and low-density lipoprotein cholesterol values. The multivariate analysis found good oral antidiabetic adherence to be associated to free pharmacy service; good antihypertensive drug adherence to the existence of comorbidities; and good lipid-lowering drug adherence to a history of ischemic heart disease, and a more experienced physician and/or female physician. Conclusion: Concordance between the two methods in assessing TA was low. Approximately one-third of the patients with type 2 diabetes mellitus presented poor TA in relation to antihypertensive, lipid-lowering, and antidiabetic medication. An improved TA was associated with a better control of the studied parameters. Comorbidities, such as ischemic heart disease and access to free pharmacy service, were identified as determinants of good TA.
机译：目的：我们分析了两种测量治疗依从性（TA）的方法之间的一致性，并研究了2型糖尿病患者中TA的决定因素。方法：我们在初级保健中心进行了横断面描述性研究，涉及320名糖尿病患者。 TA在患者访谈期间使用Haynes-Sackett（HS）依从性测试并根据药房充值数据进行测量。 TA是按药物类别（降压药，降脂药和抗糖尿病药）整体计算的。结果：通过H–S测试测得的TA差，占11.2％的患者。根据药房补充数据，全球总TA比率较差，为30.3％，口服降糖，降压和降脂药物分别为33.3％，26.6％和34.2％。两种方法之间的一致性差。通过H–S检验测得的疾病控制程度和TA之间没有关系。根据药房补充数据测得的抗糖尿病药和降压药的良好TA分别与较低的糖基化血红蛋白和舒张压有关。总体TA良好的患者表现出较低的糖基化血红蛋白，舒张压和低密度脂蛋白胆固醇值。多元分析发现，良好的口服降糖药依从性与免费药房服务有关。对合并症的存在有良好的降压药依从性;以及对缺血性心脏病史具有良好的降脂药物依从性，以及经验更丰富的医师和/或女性医师。结论：两种方法在评估TA方面的一致性较低。大约三分之一的2型糖尿病患者在抗高血压药，降脂药和抗糖尿病药方面表现出较差的TA。改进的TA与研究参数的更好控制相关。合并症，例如缺血性心脏病和获得免费药房服务，被确定为良好TA的决定因素。

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