Medication Adherence and Associated Hemoglobin A1c in Type 2 Diabetes

2004 ◽  
Vol 38 (9) ◽  
pp. 1357-1362 ◽  
Author(s):  
Kimberley Krapek ◽  
Kathleen King ◽  
Susan S Warren ◽  
Karen G George ◽  
Dorothy A Caputo ◽  
...  
2018 ◽  
Vol 42 (3) ◽  
pp. 493-501
Author(s):  
Lindsay S. Mayberry ◽  
John D. Piette ◽  
Aaron A. Lee ◽  
James E. Aikens

2020 ◽  
Vol 16 (1) ◽  
pp. 41-45
Author(s):  
Mahtab Irani ◽  
Mohammad Sarafraz Yazdi ◽  
Meisam Irani ◽  
Sina Naghibi Sistani ◽  
Sahar Ghareh

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.


2021 ◽  
Author(s):  
Olayinka Shiyanbola ◽  
Martha Maurer ◽  
Mattigan Mott ◽  
Luke Schwerer ◽  
Nassim Sarkarati ◽  
...  

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.


2019 ◽  
Vol 15 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Salam Alqudah ◽  
Anan S. Jarab ◽  
Eman A. Alefishat ◽  
Fadia Mayyas ◽  
Maher Khdour ◽  
...  

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.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 909-P
Author(s):  
BEISI LIN ◽  
WEN XU ◽  
ZHIGU LIU ◽  
DAIZHI YANG ◽  
YANNA SU ◽  
...  

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 815-P
Author(s):  
MEGUMI SHIOMI ◽  
YOICHI TANAKA ◽  
MOMOKA KUROBUCHI ◽  
TESSHU TAKADA ◽  
KATSUYA OTORI

2015 ◽  
Vol 10 (01) ◽  
pp. 10-15
Author(s):  
Nampeth Saibuathong ◽  
Nareemarn Neelapaichit

2021 ◽  
Vol 12 ◽  
pp. 204062232199026
Author(s):  
Ming Tsuey Lim ◽  
Norazida Ab Rahman ◽  
Xin Rou Teh ◽  
Chee Lee Chan ◽  
Shantini Thevendran ◽  
...  

Background: Medication adherence measures are often dichotomized to classify patients into those with good or poor adherence using a cut-off value ⩾80%, but this cut-off may not be universal across diseases or medication classes. This study aimed to examine the cut-off value that optimally distinguish good and poor adherence by using the medication possession ratio (MPR) and proportion of days covered (PDC) as adherence measures and glycated hemoglobin (HbA1c) as outcome measure among type 2 diabetes mellitus (T2DM) patients. Method: We used pharmacy dispensing data of 1461 eligible T2DM patients from public primary care clinics in Malaysia treated with oral antidiabetic drugs between January 2018 and May 2019. Adherence rates were calculated during the period preceding the HbA1c measurement. Adherence cut-off values for the following conditions were compared: adherence measure (MPR versus PDC), assessment period (90-day versus 180-day), and HbA1c target (⩽7.0% versus ⩽8.0%). Results: The optimal adherence cut-offs for MPR and PDC in predicting HbA1c ⩽7.0% ranged between 86.1% and 98.3% across the two assessment periods. In predicting HbA1c ⩽8.0%, the optimal adherence cut-offs ranged from 86.1% to 92.8%. The cut-off value was notably higher with PDC as the adherence measure, shorter assessment period, and a stricter HbA1c target (⩽7.0%) as outcome. Conclusion: We found that optimal adherence cut-off appeared to be slightly higher than the conventional value of 80%. The adherence thresholds may vary depending on the length of assessment period and outcome definition but a reasonably wise cut-off to distinguish good versus poor medication adherence to be clinically meaningful should be at 90%.


2021 ◽  
Vol 9 (1) ◽  
pp. e002033
Author(s):  
Erik Stenberg ◽  
Torsten Olbers ◽  
Yang Cao ◽  
Magnus Sundbom ◽  
Anders Jans ◽  
...  

IntroductionBariatric and metabolic surgery is an effective treatment option for type 2 diabetes (T2D). Increased knowledge regarding factors associated with diabetes remission is essential in individual decision making and could guide postoperative care. Therefore, we aimed to explore factors known to affect the chance of achieving diabetes remission after bariatric and metabolic surgery and to further investigate the impact of socioeconomic factors.Research design and methodsIn this nationwide study, we assessed all patients with T2D who underwent Roux-en-Y gastric bypass (RYGB) surgery between 2007 and 2015 in the Scandinavian Obesity Surgery Registry. Remission was defined as absence of antidiabetic medication for T2D 2 years after surgery. Multivariable logistic regression was used to evaluate factors associated with diabetes remission, with missing data handled by multiple imputations.ResultsA total of 8057 patients were included. Mean age±SD was 47.4±10.1 years, mean body mass index 42.2±5.7 kg/m2, mean hemoglobin A1c 59.0±17.33, and 61.7% (n=4970) were women. Two years after surgery, 6211 (77.1%) patients achieved T2D remission. Preoperative insulin treatment (OR 0.26, 95% CI 0.22 to 0.30), first-generation immigrant (OR 0.66, 95% CI 0.57 to 0.77), duration of T2D (OR 0.89, 95% CI 0.88 to 0.90), dyslipidemia (OR 0.71, 95% CI 0.62 to 0.81), age (OR 0.97, 95% CI 0.96 to 0.97), and high glycosylated hemoglobin A1c (HbA1c) (OR 0.99, 95% CI 0.98 to 0.99) were all associated with lower T2D remission rate. In contrast, residence in a medium-sized (OR 1.39, 95% CI 1.20 to 1.61) or small (OR 1.46, 95% CI 1.25 to 1.71) town and percentage of total weight loss (OR 1.04, 95% CI 1.03 to 1.04) were associated with higher remission rates.ConclusionAmong patients with T2D undergoing RYGB surgery, increasing age, HbA1c, and diabetes duration decreased the chance of reaching diabetes remission without cut-offs, while postoperative weight loss demonstrated a positive linear association. In addition, being a first-generation immigrant and living in a large city were socioeconomic factors having a negative association.


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