Yaşlı Diyabetik Hastalarda Kırılganlık Durumuna Göre İlaç Uyumunun Değerlendirilmesi

Abstract

AMAÇ: Bu çalışma, yaşlı diyabet hastalarında kırılganlık ile ilaç uyumu arasındaki ilişkiyi araştırmayı amaçladı. GEREÇ ve YÖNTEM: Kesitsel nitelikteki bu çalışma, Mart-Kasım 2021 tarihleri arasında Konya Şehir Hastanesi’nde gerçekleştirildi ve 60 yaş ve üzerindeki 194 diyabet hastası dahil edildi. Kırılganlık durumu FRAIL ölçeği ile, ilaç uyumu ise 8 maddelik morisky ilaç uyumu ölçeği ile değerlendirildi. Komorbidite yükü, Modifiye Charlson Komorbidite indeksi kullanılarak ölçüldü. İstatistiksel analizlerde ki-kare testi, Mann- Whitney U testi, Kruskal-Wallis testi ve lojistik regresyon modelleri kullanıldı. BULGULAR: Katılımcıların medyan yaşı 67 idi (ÇEY: 64-71) ve %69,6’sı kadındı. Kırılganlık prevalansı %50 olarak saptandı ve kırılganlık ile ilaç uyumu arasında anlamlı bir ilişki bulunmadı (p=0,318). Ancak, düşük uyumun bağımsız belirleyicileri arasında daha kısa diyabet süresi (p=0,049), diyabet eğitimi almamış olmak (p=0,020) ve yüksek HbA1c düzeyleri (p=0,010) yer aldı. Düşük ilaç uyumu gösteren hastaların kan şekeri takibini daha az sıklıkla yaptığı (p=0,008) ve hastaneye yatış risklerinin daha yüksek olduğu görüldü. SONUÇ: Yaşlı diyabet hastalarında kırılganlık ile ilaç uyumu arasında anlamlı bir ilişki saptanmadı. Bunun yerine, diyabet eğitimi, glisemik kontrol ve öz izlem uygulamaları ilaç uyumunda daha belirleyici faktörler olarak öne çıktı. Bu bulgular, yapılandırılmış eğitim programlarının ve bireyselleştirilmiş müdahalelerin ilaç uyumunu artırmadaki önemini vurgulamaktadır. Kırılganlık ve uyum arasındaki karmaşık ilişkinin daha iyi anlaşılabilmesi için daha geniş örneklemli ve uzunlamasına takipli çalışmalara ihtiyaç vardır.

Keywords

• Diabetes mellitus
• kırılganlık
• ilaç uyumu
• yaşlı

Evaluation of Medication Adherence According to Frailty Status in Older Diabetic Patients

Abstract

OBJECTIVE: This study aimed to investigate the relationship between frailty and medication adherence in elderly patients with diabetes mellitus. MATERIALS and METHODS: A cross-sectional study was conducted at Konya City Hospital between May and November 2021, including 194 diabetic patients aged 60 years and older. Frailty status was assessed using the FRAIL scale, and medication adherence was evaluated with the 8-item morisky medication adherence scale The Modified Charlson Comorbidity index was used to quantify comorbidity burden. Statistical analyses included the chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and logistic regression models. RESULTS: The median age of the participants was 67 years (IQR: 64-71), and 69.6% were female. The prevalence of frailty was 50%, and no significant association was found between frailty and medication adherence (p=0.318). However, variables independently associated with low adherence included shorter diabetes duration (p=0.049), lack of diabetes education (p=0.020), and higher HbA1c levels (p=0.010). Patients with low adherence monitored their blood glucose significantly less frequently (p=0.008) and had a higher risk of hospitalization. CONCLUSION: Frailty was not significantly associated with medication adherence in elderly diabetic patients. Instead, diabetes education, glycemic control, and self-monitoring practices played a more significant role. These findings highlight the importance of structured education programs and individualized interventions to improve adherence. Future studies with larger sample sizes and longitudinal follow-up are needed to better understand the complex interplay between frailty and adherence.

Keywords

• Diabetes mellitus
• frailty
• medication adherence
• elderly

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