Yaşlı Diyabetik Hastalarda Kırılganlık Durumuna Göre İlaç Uyumunun Değerlendirilmesi

Year 2025, Volume: 8 Issue: 2, 62 - 70, 28.08.2025

İlhan Yapıcı , Betül Çiğdem Yortanlı , Mikail Dağ , Fatih Saçkan , Muhammet Cemal Kızılarslanoğlu

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

Ethical Statement

Çalışma, etik ilkelere uygun olarak gerçekleştirilmiş ve 26 Nisan 2021 tarihinde, karar no: 30162 ile Hamidiye Sağlık Bilimleri Üniversitesi Bilimsel Araştırmalar Etik Kurulu’ndan onay alınmıştır. Veri toplama öncesinde tüm katılımcılardan yazılı bilgilendirilmiş onam alınmıştır.

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

Ethical Statement

The study was carried out in accordance with ethical principles and was approved by the Hamidiye Scientific Research Ethics Committee of the University of Health Sciences on April 26, 2021 (decision no: 30162). Written informed consent was obtained from all participants prior to data collection.

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