COVID-19 PANDEMİ DÖNEMİNDE DİYABET HASTASININ TEDAVİYE UYUM DURUMUNUN DEĞERLENDİRİLMESİ

Abstract

Amaç: Diyabet, yönetimi çok bileşenli olan kronik, kompleks bir hastalıktır. Tedavi başarısı ancak iyi bir tedavi uyumuyla sağlanabilmektedir. Bu çalışmada, diyabet hastalarının COVID-19 (Koronavirüs hastalığı) pandemisi döneminde tedaviye uyum durumu ve bu durumu etkileyen faktörlerin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışma, The Medication Compliance Questionnaire (MCQ) ve Dünya Sağlık Örgütü (DSÖ) uyum klavuzu 2003’e göre belirlenmiş sorularından oluşan bir anket ile 474 diyabetik hasta ile gerçekleştirilmiştir. Bulgular: MCQ ölçeğine göre tedaviye uyumsuzluk oranı %82,3 idi. Tedaviye uyumsuzluk, oral antidiyabetik (OAD) ilaç kullanımı, sigara içme durumu, glukolize hemoglobinin (HbA1c) <%7 olması ve hasta yorum sorularından; ‘’düzenli doktor takibim yok’’,’’doktorumla iyi iletişim kuramıyorum’’, ‘’şekerim belirlenen hedef değerde değil’’,’’ilaçlarım kullanım yönünden yeterince konforlu değil’’ ifadeleriyle ilişkili bulunmuştur (p=0,011; 0,010; 0,014; 0,011; 0,002; 0,019; 0,000). İnsülin kullanan, HbA1c değeri ≥%7 olan hastalar ise tedaviye daha uyumlu olarak tespit edilmiştir. Sonuç: Bu çalışmada klasik sonuçlardan farklı olarak HbA1c <%7 ve OAD kullanmakta olan diyabetik hastaların uyumsuzluğu gündeme getirilmiştir. COVID-19 pandemisi döneminde insülin kullanan ve hastalık süresi uzun olan hastalar tedaviye daha bağlı kalmışlardır. Doktor takibinin olmaması ve doktorla iyi iletişim kuramama uyumsuzluk açısından belirleyici olmuştur. 

Keywords

• Diyabetes mellitus
• tedavi uyumu
• HbA1c

DIABETIC PATIENTS’ COMPLIANCE WITH TREATMENT DURING COVID-19 PANDEMIC PERIOD

Abstract

Objective: Diabetes mellitus is a chronic, complex disease with many components that must be managed. Treatment success depends on excellent treatment compliance. In this study, we aimed to evaluate the treatment adherence of diabetic patients during the COVID-19 (Coronavirus Disease) pandemic and the factors affecting this condition. Material and Methods: The study was carried out on 474 diabetic patients with a questionnaire consisting of questions based on The Medication Compliance Questionnaire (MCQ) and the World Health Organization (WHO) 2003 compliance guideline. Results: The rate of non-compliance with the treatment based on the MCQ scale was 82.3%. Non-compliance with treatment was significantly associated with oral antidiabetic (OAD) drug use, smoking status, glycosylated hemoglobin (HbA1c) <7%, and patient comments of “I don’t have regular doctor follow-up,” “I can’t communicate well with my doctor,” “My blood glucose is not at the target value,” and “My medications are not comfortable enough for use”(p=0.011; 0.010; 0.014; 0.011; 0.002; 0.019; 0.001). Patients under insulin treatment or with an HbA1c value of ≥7% were found to be more compliant with the treatment. Conclusion: Unlike the classical results, the incompatibility of diabetic patients with HbA1c <7% and under OADs with the treatment was emphasized. Patients using insulin and with advanced duration of diabetes were more compliant with the treatment in the stressful period of the COVID-19 pandemic. Lack of follow- up by the doctor and low patient effort to communicate with the doctor have been decisive factors in the non-compliance. 

Keywords

• Diabetes mellitus
• compliance
• HbA1c
• oral antiglycemic agent

Supporting Institution

prof.dr.cemil taşcıoğlu city hospital

Thanks

I would like to thanks my teachers Prof.Dr.Tufan Tukek ve Prof.Dr.Mine Adaş

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