Medication Adherence in Patients with Diabetes Who Are Being Treated in a University Hospital Endocrinology Department

Year 2019, , 227 - 234, 28.06.2019

Hatice Delibas , Atilla Senih Mayda , Muammer Yilmaz , Hafize Titiz Yilmaztepe

https://doi.org/10.18521/ktd.437305

Abstract

Aim: This study aims to
investigate knowledge and motivation levels of diabetic patients related to
medication adherence, and the factors effecting medication adherence.

Material and Method: Study sample in
this descriptive type of study consists of 85 patients who applied to
Endocrinology outpatient clinic of a university hospital, have been diagnosed with
diabetes mellitus at least one year before and volunteered to participate in
the study. A survey questioning personal information, socio-demographical
properties and daily habits, and "Modified Morisky Adherence Scale"
were performed on all patients by face-to-face interview. Analysis of data was
carried out on SPSS 15.0 software using chi-square, Fischer's exact chi-square
and Student t tests.

Results: Mean age of the participants was
55.58 ±13.35; fifty six (65.9%) of them were women. Fifty five (65.9%) patients
stated they were paying attention to eat regular meals and balanced diet, 30
(35.3%) patients stated they were exercising regularly. For medication
adherence, 64 (75.3%) patients were determined to have high motivation level,
76 (89.4%) patients were determined to have high knowledge level. Those who
paid attention to regular meals and balanced diet had significantly higher
motivation and knowledge levels.

Conclusion: Since diabetes
medications require dietary regulation, it is important that patients are
encouraged to pay attention for eating regular meals and have balanced diet.
Education of patients and their relatives to enhance their motivation would be
beneficial for developing habits to adhere to their medications.

Amaç: Bu araştırma,
diyabetli hastaların ilaç uyumu konusunda bilgi ve motivasyon durumlarını ve
ilaç uyumlarını etkileyen faktörleri incelemeyi amaçlamaktadır.

Materyal ve
Metod: Tanımlayıcı tipteki bu araştırmanın örneklemini bir
üniversite hastanesinin Endokrinoloji polikliniğine başvuran en az bir yıldır
diyabet tanısı olan ve araştırmaya katılmayı kabul eden 85 hasta oluşturmuştur.
Hastalara kişisel bilgiler, sosyo-demografik özellikler, yaşam alışkanlıklarını
içeren anket formu ve ‘Modifiye Morisky İlaç Uyum Ölçeği’ yüz yüze görüşme
tekniğiyle uygulanmıştır. Verilerin analizinde, SPSS 15.0 programı ile,
Ki-kare, Fisher’in kesin ki kare ve Student t testi yöntemleri kullanılmıştır.

Bulgular: Katılımcıların
yaş ortalaması 55.58 ±13.35 olup, 56 (%65.9)’sı kadındır. 56 (%65.9) kişi
düzenli ve dengeli beslenmeye dikkat ettiğini, 30 (%35.3) kişi ise düzenli
egzersiz yaptığını belirtmiştir. İlaç uyumu konusunda 64 (%75.3) kişinin
motivasyonu yüksek, 76 (%89.4) kişinin ise bilgi düzeyi yüksek olarak
saptanmıştır. Düzenli ve dengeli beslenmeye dikkat eden hastaların motivasyon
ve bilgi düzeyleri anlamlı olarak yüksek bulunmuştur.

Sonuç: Diyabet
ilaçlarının bir beslenme düzenine göre kullanılması gerektiğinden, uyumu
arttırmak için düzenli ve dengeli beslenmenin teşviki önemlidir. Hastalara ve
yakınlarına motivasyonu arttırıcı eğitimler verilmesinin, düzenli ilaç kullanma
alışkanlığı geliştirme konusunda faydalı olacağı düşünülmektedir.

Keywords

Diabetes mellitus, medication adherence, motivation

Bir Üniversite Hastanesinin Endokrinoloji Bölümünde Tedavi Gören Diabetli Hastalarda İlaç Uyumu

Abstract

References

• REFERENCES1. Atilla S, Bağci Bosi AT. Toplum Beslenmesi, Güler Ç, Akın L, (eds) Halk Sağlığı Temel Bilgiler. Hacettepe Üniversitesi Yayınları, Ankara 2012:1210-13482. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: Prevalance, numerical estimates, and projections. Diabetes Care. 1998;21:1414-1431.3. Wild S, Roglic G, Green A, et al. Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-1053.4. International Diabetes Federation (IDF) Diabetes Atlas. Sixth edition. 27 May 2013 http://www.idf.org/diabetesatlas.5. World Health Organization. Media Centre. Diabetes. 2015;312. Jan 2015 http://www.who.int/mediacentre/factsheets/fs312/en/. 6. Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalance and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28:169-180. doi:10.1007/s10654-013-9771-57. Satman I, Yılmaz T, Sengül A, et al. Population-Based Study of Diabetes and Risk Characteristics in Turkey: Results of the Turkish Diabetes Epidemiology Study (TURDEP). Diabetes Care. 2002;25:1551-1556.8. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837–853.9. Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27:1218-1224.10. Rubin RR. Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med 2005;118(5):27-34 doi:10.1016/j.amjmed.2005.04.01211. Krass I, Schieback P, Dhippayom T. Adherence to diabetes medication: a systematic review. Diabet Med. 2014. doi:10.1111/dme.1265112. Vural B, Acar ÖT, Topsever P, et al. Reliability and Validity of Turkish Version of Modified Morisky Scale. Turkish Family Physician. 2012;3(4):17-20.13. American Diabetes Association. Nutrition Recommendations and Interventions for Diabetes: A position statement of the American Diabetes Association. Diabetes Care. 2007;30:48–65. doi:10.2337/dc07-S04814. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393-403.15. T.C. Sağlık Bakanlığı. Erişkin Diyabetli Bireyler İçin Eğitimci Rehberi. 2014;945. http://beslenme.gov.tr/content/files/diyabet/DiyabetliBireylerIcinEgitimciRehberi.pdf16. Arslan E. Tip 2 Diabetes mellituslu hastaların tedaviye uyumlarını etkileyen faktörler. Uzmanlık tezi, Diyarbakır: Dicle Üniversitesi Tıp Fakültesi, Halk Sağlığı Bölümü, 2011.17. Gün İ, Günay O, Naçar M, et al. Adherence of Diabetic Patients to the Recommendations on Diabetes in Kayseri. Turkiye Klinikleri J Med Sci. 2010;30(6):2004-2010.18. Cohen HW, Shmukler C, Ullman R, et al. Measurements of medication adherence in diabetic patients with poorly controlled HbA1C. Diabet Med. 2010;27:210-216. doi:10.1111/j.1464-5491.2009.02898.x19. Parada H, Horton LA, Cherrington A, et al. Correlates of medication nonadherence among Latinos with type 2 diabetes. Diabetes Educ. 2012;38:552-561. doi:10.1177/014572171244521520. Egede LE, Gebregziabher M, Hunt KJ, et al. Regional, geographic, and ethnic differences in medication adherence among adults with Type 2 diabetes. Ann Pharmacother. 2011;45:169–178.21. Lerman I, Diaz JP, Ibarguengoitia ME, et al. Nonadherence to insulin therapy in low-income, type 2 diabetic patients. Endocr Pract. 2009;15:41–46.22. Aikens JE, Piette JD. Longitudinal association between medication adherence and glycaemic control in Type 2 diabetes. Diabet Med. 2013;30:338-344. doi:10.1111/dme.1204623. Peeters B, Van Tongelen I, Boussery K, et al. Factors associated with medication adherence to oral hypoglycaemic agents in different ethnic groups suffering from type 2 diabetes: a systematic literature review and suggestions for further research. Diabet Med. 2011;28:262-275. doi:10.1111/j.1464-5491.2010.03133.x24. Peyrot M, Rubin RR, Kruger DF, et al. Correlates of insulin injection omission. Diabetes Care. 2010;33:240–245. doi:10.2337/dc09-134825. Uzoma CU, Feldman RH. Psychosocial factors influencing inner city black diabetic patients’ adherence with insulin. Health Educ. 1989;20:29–32.26. Shams MEE, Barakat EAME. Measuring the rate of therapeutic adherence among outpatients with T2DM in Egypt. Saudi Pharm J. 2010;18:225-232. doi:10.1016/j.jsps.2010.07.00427. Raum E, Kramer HU, Ruter G, et al. Medication non-adherence and poor glycaemic control in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2012;97:377-384.28. Bean D, Cundy T, Petrie KJ. Ethnic differences in illness perceptions, self-efficacy and diabetes self-care. Psychol Health. 2007;22:787–811. doi:10.1080/1476832060097624029. Aikens JE, Piette JD. Diabetes patients’ medication underuse, illness outcomes, and beliefs about antihyperglycemic and antihypertensive treatments. Diabetes Care. 2009;32:19-24. doi:10.2337/dc08-153330. Davies MJ, Gagliardino JJ, Gray LJ, et al. Real-world factors affecting adherence to insulin therapy in patients with Type 1 or Type 2 diabetes mellitus: a systematic review. Diabet Med. 2013;30:512-524. doi:10.1111/dme.12128