Out-of-home informal support important for medication adherence, diabetes distress, hemoglobin A1c among adults with type 2 diabetes

Background. Medication adherence is negatively related to both diabetes distress (DD) and depressive symptoms (DS). Past research suggests gender differences in adherence, DD, and DS. A gap exists in determining if gender differences in adherence are mediated by DD and DS, or if gender moderates differences in adherence by DD/DS. Aims. This study investigated the relationship between gender, DD, DS, and medication adherence and tested for mediating and moderating effects on medication adherence among American Indian adults with type 2 diabetes. Method. The Maawaji idi-oog mino-ayaawin (Gathering for Health) study was a community-based participatory research collaboration with five American Indian tribes. Participants, randomly recruited from clinic records, shared information during computer-assisted personal interviews. This study includes the 166 participants who reported using medications to treat their diabetes. The relationship between gender, DD, DS, and medication adherence are explored. Possible mediating and moderating effects on medication were tested using regression and path analysis. Results. Females had higher levels of DD and DS and lower levels of medication adherence. Higher levels of DD and DS were both associated with lower medication adherence. No evidence was found that gender moderates the relationship between DD or DS and medication adherence. Instead, DD and DS mediated the relationship between gender and medication adherence. Conclusions. Medication adherence differences in male and female patients may be attributable to DD and DS. The present research highlights both DD and DS as targets for clinicians and researchers alike.

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Depressive Symptoms, Diabetes Distress and Serum Hemoglobin A1C in South Asians With Type 2 Diabetes Mellitus Living in Canada

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2016.12.008 ◽

2018 ◽

Vol 42 (1) ◽

pp. 3

Author(s):

Tomoyuki Kawada

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Depressive Symptoms ◽

Hemoglobin A1c ◽

South Asians ◽

Diabetes Distress

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Evaluation of Adherence to Oral Hypoglycemic Agent Prescription in Patients with Type 2 Diabetes

The Review of Diabetic Studies ◽

10.1900/rds.2020.16.41 ◽

2020 ◽

Vol 16 (1) ◽

pp. 41-45

Author(s):

Mahtab Irani ◽

Mohammad Sarafraz Yazdi ◽

Meisam Irani ◽

Sina Naghibi Sistani ◽

Sahar Ghareh

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

Hemoglobin A1c ◽

Statistical Tests ◽

Personal Characteristics ◽

Adherence To Treatment ◽

Adherence To Medication ◽

Treatment Of Diabetes ◽

Global Health Problem

BACKGROUND: Diabetes is a global health problem that has affected more than 400 million people worldwide. Adherence to treatment is considered to be one of the most impor tant and deterministic factors in the treatment of diabetes. This study investigates medication adherence and factors af fecting it in patients with type 2 diabetes. METHODS: This crosssectional study investigated 136 patients with type 2 diabetes in 2018-2019. Data collection was done using a checklist that included information on personal characteristics, medication, and healthcare. The collected data were analyzed by statistical tests in SPSS 25 software. RESULTS: 79.4% of the patients adhered to prescribed medication. Medication adherence had no significant relationship with taking other dr ugs, fasting blood sugar (FBS), and the daily number of hypoglycemic tablets (p > 0.05). However, adherence to medication was significantly associated with age, gender, income, hemoglobin A1c, medication period, and hypoglycemia (p < 0.05). CONCLUSIONS: Higher levels of adherence werè obser ved among females aged below 60 years, with higher income, a hemoglobin A1c level below 7%, a medication period of less than 10 years, and among patients without hypoglycemia. Regarding drug type, adherence levels were lower in people taking glibenclamide.

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A Feasibility Pilot Trial of a Peer-support Educational Behavioral Intervention to Improve Diabetes Medication Adherence in African Americans

10.21203/rs.3.rs-1072559/v1 ◽

2021 ◽

Author(s):

Olayinka Shiyanbola ◽

Martha Maurer ◽

Mattigan Mott ◽

Luke Schwerer ◽

Nassim Sarkarati ◽

...

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

African Americans ◽

Effect Size ◽

Self Efficacy ◽

Hemoglobin A1c ◽

The United States ◽

Post Intervention ◽

Phone Calls

Abstract BackgroundAfrican Americans are twice as likely to die from diabetes, compared to other racial and ethnic groups in the United States. Poor adherence to diabetes medications is common among African Americans and contributes to these disproportionally worse outcomes. A pilot study was conducted to determine the feasibility and acceptability of a peer-supported intervention targeting diabetes and medication beliefs, communication, and self-efficacy skills to enhance medication adherence among African Americans with type 2 diabetes. MethodsBased on the extended self-regulatory model and information-motivation-behavioral skills model, this intervention was piloted using a single group pre/post-intervention study design at two sites. Seventeen African Americans who self-reported as adherent to diabetes medicines (ambassadors), were paired with 22 African Americans with self-reported poor medication adherence (buddies). Measures assessed at baseline and one-month post-intervention included glycemic control (hemoglobin A1c), self-reported medication adherence, diabetes beliefs, concerns about diabetes medicines, and diabetes self-efficacy. Wilcoxon signed rank tests assessed for differences in mean scores of outcome variables at baseline compared with 3-months follow-up. Semi-structured 60-minute interviews were conducted with each buddy to explore their acceptability of the intervention. To ensure the rigor of the qualitative data, we focused on analytic criteria such as credibility, confirmability, and transferability.ResultsMost buddies and ambassadors were female and about 56 years old. Feasibility outcomes included recruitment success rates of 73% for buddies and 85% for ambassadors relative to our goals. Retention rate for hemoglobin A1c and medication adherence outcome assessment was 95% for buddies. Both buddies and ambassadors had excellent intervention adherence, with buddies having a mean attendance of 7.76 out of 8 sessions/phone calls and ambassadors completing > 99% of the 105 intervention calls with Buddies. Results showed a signal of change in hemoglobin A1c (effect size = 0.14) and medication adherence (effect size = 0.35) among buddies, reduction in buddies’ negative beliefs about diabetes and an increase in necessity beliefs of diabetes medicines. Summative interviews with buddies showed they valued ambassador’s encouragement of self-management behaviors. ConclusionsResults support conduct of an efficacy trial to address medication adherence for African Americans with type 2 diabetes using a peer-supported tailored intervention.

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Factors Associated with Poor Hemoglobin A1c Control in Patients with Type 2 Diabetes

Current Diabetes Reviews ◽

10.2174/1573399814666180510144858 ◽

2019 ◽

Vol 15 (2) ◽

pp. 164-170 ◽

Cited By ~ 1

Author(s):

Salam Alqudah ◽

Anan S. Jarab ◽

Eman A. Alefishat ◽

Fadia Mayyas ◽

Maher Khdour ◽

...

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

Glycemic Control ◽

Hemoglobin A1c ◽

Diabetes Management ◽

Blood Glucose Control ◽

Clinical Pharmacy Service ◽

Diabetes Clinic ◽

Factors Associated

Background: The limited implementation of clinical pharmacy service programs and the lack of studies identifying barriers to achieve blood glucose control have all attributed to the increased proportion of type 2 diabetes patients who have poor glycemic control in Jordan. Objective: To explore factors associated with higher HbA1c in patients with type 2 diabetes in Jordan. Methods: Variables including socio-demographics, disease and treatment factors were collected from171 patients with type2 diabetes at an outpatient diabetes clinic in Amman. Validated questionnaires were used to assess medication adherence, self-care activities, diabetes knowledge and healthrelated quality of life in addition to data collected from medical records. After the single-predictor analysis, stepwise linear regression was performed to develop a model with variables that best predicted hemoglobin A1c. Results: Medication adherence was inversely associated with HbA1c values (β = -0.275; t = 2.666; P < 0.01), indicating better glycemic control. Receiving insulin therapy was also associated with less HbA1c values and better glycemic control (β = - 0.184; t = 2.080; P < 0.05). Patients who had one or more comorbid conditions (β = 0.215; t = 2.264; P < 0.05) and those with longer diabetes duration (β = 0.092; t = 1.339; P < 0.05) were found to have significantly higher HbA1c values. Conclusion: Emphasizing medication adherence, particularly for patients with longer duration of diabetes and those with multiple comorbid diseases should be strongly considered in future diabetes management programs implemented to improve glycemic control in patients with type 2 diabetes.

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The Association between Diabetes-Related Distress and Medication Adherence in Adult Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

Journal of Diabetes Research ◽

10.1155/2020/4760624 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Irene A. Kretchy ◽

Augustina Koduah ◽

Thelma Ohene-Agyei ◽

Vincent Boima ◽

Bernard Appiah

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Medication Adherence ◽

Diabetes Management ◽

Cross Sectional Study ◽

Diabetes Distress ◽

Sectional Study ◽

Cross Sectional

Background. Type 2 diabetes mellitus (T2DM) is a major public health problem associated with distress. T2DM can affect health outcomes and adherence to medications. Little is however known about the association between diabetes distress and medication adherence among patients with T2DM in Ghana. Objective. The objective of the present study is twofold: to estimate distress associated with T2DM and to examine its association with medication adherence. Methods. A hospital-based cross-sectional study was conducted among 188 patients with T2DM recruited from a diabetes specialist outpatient clinic at the Pantang Hospital in Accra, Ghana. Data were obtained using the Problem Areas In Diabetes (PAID) scale and the Medication Adherence Report Scale. Results. The findings showed that about 44.7% of the patients showed high levels of diabetes-related distress. Poor adherence to medications was recorded in 66.5% of the patients. Patients who were highly distressed had 68% lower odds of adhering to their medications compared to those who were not (OR: 0.32, 95% CI: 0.15-0.65). A principal component analysis revealed four areas of T2DM distress which were conceptualized as negative emotions about diabetes, dietary concerns and diabetes care, dissatisfaction with external support, and diabetes management helplessness. Conclusion. Our findings suggest that diabetes distress is a significant determinant of medication adherence behaviour in patients with T2DM. Thus, incorporating routine screening for distress into the standard diabetes care within the Ghanaian health system and having health practitioners adopt holistic approaches to diabetes management will be important context-specific interventions to improve adherence and health outcomes of people living and coping with T2DM.

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