1
|
Chen HM, Huang CN, Lin RT, Su BY. The impact of neuropsychological functions on self-care/self-management of type 2 diabetes in middle-aged people: a scoping review and meta-analysis. Expert Rev Endocrinol Metab 2023; 18:525-540. [PMID: 37815866 DOI: 10.1080/17446651.2023.2268171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023]
Abstract
INTRODUCTION This study aimed to investigate the impact of neuropsychological functions on self-care/self-management in middle-aged individuals with type 2 diabetes (T2DM). AREAS COVERED A comprehensive literature search was conducted from January 2012 to April 2023 across multiple databases. Ten articles were included in the scoping review, and 3 articles were included in the meta-analysis. The findings consistently indicated an association between reduced neuropsychological functions and poor self-care/self-management in this population. Memory functions, executive functions, and other domains were found to be significantly related to self-care/self-management, including diet management, exercise, blood glucose monitoring, and foot care. EXPERT OPINION This study highlights the importance of considering neuropsychological factors in understanding and improving diabetes management outcomes. The findings underscore the need for comprehensive neuropsychological assessments and the development of targeted interventions to address specific vulnerable domains. Future research should focus on elucidating underlying mechanisms, addressing methodological inconsistencies, and exploring the effectiveness of interventions targeting neuropsychological impairments. Incorporating technology and personalized approaches into diabetes management can enhance self-care/self-management and clinical outcomes in individuals with T2DM.
Collapse
Affiliation(s)
- Hsiao-Mei Chen
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chien-Ning Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ro-Ting Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Bei-Yi Su
- Department of Psychology, Chung-Shan Medical University, Taichung, Taiwan
- Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
2
|
Atonal-Flores B, León-Vázquez MDLL, Barranco-Juarez A. [Indicators of diabetes mellitus after liraglutide, sitagliptin/metformin, linagliptin, and sitagliptin]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:489-495. [PMID: 37540652 PMCID: PMC10484544 DOI: 10.5281/zenodo.8200442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/10/2023] [Indexed: 08/06/2023]
Abstract
Background The control of diabetes mellitus is multifactorial, the different therapeutic options make it necessary to compare the effectiveness with previous therapeutic schemes. Objective Analize the indicators of control of diabetes mellitus after incorporating liraglutide, sitagliptin/metformin, linagliptin, and sitagliptin. Methods Observational, analytical, longitudinal study. Glucose, glycosylated hemoglobin, and blood pressure were compared after the inclusion of new cues in patients with diabetes mellitus; in addition to the control indicators reported in the unit in october, november, and december 2000, with those of 2021 in the same months. A descriptive analysis was performed, T for related samples and McNemar, a value of < .05 was considered significant, a confidence level of 95%, with the IBM-SPSS 24 software. Results 352 files were analyzed, 59% women, aged 26 to 88 years, and the percentage of control decreased after the change of scheme (38.4% vs 35.8%) without a statistical difference (p .503). There was no statistical difference between the levels of glucose, glycated hemoglobin, weight, and blood pressure before and six months after the change. In the unit, the regimen glycemic control indicator improved in October, November, and December 2020 compared to the same months in 2021, it increased (from 17.2, 18.7, and 16.3, to 41.6, 47.2, and 46.5%). Blood pressure control went from 64.5, 66.7, and 67 to 82.4, 85.1, and 83.1%. Conclusions The control indicators in the unit improved, however, the patients who used the new keys did not show any difference.
Collapse
Affiliation(s)
- Beatriz Atonal-Flores
- Instituto Mexicano del Seguro Social. Unidad de Medicina Familiar No. 7, Servicio de Epidemiología. Zacatelco, Tlaxcala, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - María de la Luz León-Vázquez
- Instituto Mexicano del Seguro Social, Coordinación de Planeación y Enlace Institucional, Servicio Coordinación de Investigación. Tlaxcala, Tlaxcala, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Armando Barranco-Juarez
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 7, Dirección Médica. Zacatelco, Tlaxcala, MéxicoInstituto Mexicano del Seguro SocialMéxico
| |
Collapse
|
3
|
O'Connor S, Blais C, Mésidor M, Talbot D, Poirier P, Leclerc J. Great diversity in the utilization and reporting of latent growth modeling approaches in type 2 diabetes: A literature review. Heliyon 2022; 8:e10493. [PMID: 36164545 PMCID: PMC9508412 DOI: 10.1016/j.heliyon.2022.e10493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/09/2022] [Accepted: 08/25/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction The progression of complications of type 2 diabetes (T2D) is unique to each patient and can be depicted through individual temporal trajectories. Latent growth modeling approaches (latent growth mixture models [LGMM] or latent class growth analysis [LCGA]) can be used to classify similar individual trajectories in a priori non-observed groups (latent groups), sharing common characteristics. Although increasingly used in the field of T2D, many questions remain regarding the utilization of these methods. Objective To review the literature of longitudinal studies using latent growth modeling approaches to study T2D. Methods MEDLINE (Ovid), EMBASE, CINAHL and Wb of Science were searched through August 25th, 2021. Data was collected on the type of latent growth modeling approaches (LGMM or LCGA), characteristics of studies and quality of reporting using the GRoLTS-Checklist and presented as frequencies. Results From the 4,694 citations screened, a total of 38 studies were included. The studies were published beetween 2011 and 2021 and the length of follow-up ranged from 8 weeks to 14 years. Six studies used LGMM, while 32 studies used LCGA. The fields of research varied from clinical research, psychological science, healthcare utilization research and drug usage/pharmaco-epidemiology. Data sources included primary data (clinical trials, prospective/retrospective cohorts, surveys), or secondary data (health records/registries, medico-administrative). Fifty percent of studies evaluated trajectory groups as exposures for a subsequent clinical outcome, while 24% used predictive models of group membership and 5% used both. Regarding the quality of reporting, trajectory groups were adequately presented, however many studies failed to report important decisions made for the trajectory group identification. Conclusion Although LCGA were preferred, the contexts of utilization were diverse and unrelated to the type of methods. We recommend future authors to clearly report the decisions made regarding trajectory groups identification. There is a growing body of literature on trajectory modeling in type 2 diabetes. Latent class growth analysis can be used in many different contexts. The current reporting of methods used should be improved.
Collapse
Affiliation(s)
- Sarah O'Connor
- Research Centre, Institut universitaire de Cardiologie et Pneumologie de Québec-Université Laval (IUCPQ-UL), 2725 Ch. Ste-Foy, Quebec City, Quebec, G1V 4G5, Canada.,Faculty of Pharmacy, Université Laval, Ferdinand Vandry Pavillon, 1050 de La Médecine Avenue, Quebec City, Quebec, G1V 0A6, Canada
| | - Claudia Blais
- Faculty of Pharmacy, Université Laval, Ferdinand Vandry Pavillon, 1050 de La Médecine Avenue, Quebec City, Quebec, G1V 0A6, Canada.,Bureau D'information et D'études en Santé des Populations, Institut National de Santé Publique Du Québec, 945, Wolfe Avenue, Quebec City, Quebec, G1V 5B3, Canada
| | - Miceline Mésidor
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Ferdinand Vandry Pavillon, 1050 de La Médecine Avenue, Quebec City, Quebec, G1V 0A6, Canada.,Research Centre, CHU de Québec - Université Laval, 2400 D'Estimauville Avenue, Québec, QC, G1E 6W2, Canada
| | - Denis Talbot
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Ferdinand Vandry Pavillon, 1050 de La Médecine Avenue, Quebec City, Quebec, G1V 0A6, Canada.,Research Centre, CHU de Québec - Université Laval, 2400 D'Estimauville Avenue, Québec, QC, G1E 6W2, Canada
| | - Paul Poirier
- Research Centre, Institut universitaire de Cardiologie et Pneumologie de Québec-Université Laval (IUCPQ-UL), 2725 Ch. Ste-Foy, Quebec City, Quebec, G1V 4G5, Canada.,Faculty of Pharmacy, Université Laval, Ferdinand Vandry Pavillon, 1050 de La Médecine Avenue, Quebec City, Quebec, G1V 0A6, Canada
| | - Jacinthe Leclerc
- Research Centre, Institut universitaire de Cardiologie et Pneumologie de Québec-Université Laval (IUCPQ-UL), 2725 Ch. Ste-Foy, Quebec City, Quebec, G1V 4G5, Canada.,Faculty of Pharmacy, Université Laval, Ferdinand Vandry Pavillon, 1050 de La Médecine Avenue, Quebec City, Quebec, G1V 0A6, Canada.,Department of Nursing, Université Du Québec à Trois-Rivières, 3351 des Forges Boulevard, Trois-Rivières, Quebec, G8Z 4M3, Canada
| |
Collapse
|
4
|
Seng JJB, Monteiro AY, Kwan YH, Zainudin SB, Tan CS, Thumboo J, Low LL. Population segmentation of type 2 diabetes mellitus patients and its clinical applications - a scoping review. BMC Med Res Methodol 2021; 21:49. [PMID: 33706717 PMCID: PMC7953703 DOI: 10.1186/s12874-021-01209-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 01/13/2021] [Indexed: 12/25/2022] Open
Abstract
Background Population segmentation permits the division of a heterogeneous population into relatively homogenous subgroups. This scoping review aims to summarize the clinical applications of data driven and expert driven population segmentation among Type 2 diabetes mellitus (T2DM) patients. Methods The literature search was conducted in Medline®, Embase®, Scopus® and PsycInfo®. Articles which utilized expert-based or data-driven population segmentation methodologies for evaluation of outcomes among T2DM patients were included. Population segmentation variables were grouped into five domains (socio-demographic, diabetes related, non-diabetes medical related, psychiatric / psychological and health system related variables). A framework for PopulAtion Segmentation Study design for T2DM patients (PASS-T2DM) was proposed. Results Of 155,124 articles screened, 148 articles were included. Expert driven population segmentation approach was most commonly used, of which judgemental splitting was the main strategy employed (n = 111, 75.0%). Cluster based analyses (n = 37, 25.0%) was the main data driven population segmentation strategies utilized. Socio-demographic (n = 66, 44.6%), diabetes related (n = 54, 36.5%) and non-diabetes medical related (n = 18, 12.2%) were the most used domains. Specifically, patients’ race, age, Hba1c related parameters and depression / anxiety related variables were most frequently used. Health grouping/profiling (n = 71, 48%), assessment of diabetes related complications (n = 57, 38.5%) and non-diabetes metabolic derangements (n = 42, 28.4%) were the most frequent population segmentation objectives of the studies. Conclusions Population segmentation has a wide range of clinical applications for evaluating clinical outcomes among T2DM patients. More studies are required to identify the optimal set of population segmentation framework for T2DM patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01209-w.
Collapse
Affiliation(s)
- Jun Jie Benjamin Seng
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,SingHealth Regional Health System PULSES Centre, Singapore Health Services, Outram Rd, Singapore, 169608, Singapore
| | | | - Yu Heng Kwan
- SingHealth Regional Health System PULSES Centre, Singapore Health Services, Outram Rd, Singapore, 169608, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Sueziani Binte Zainudin
- Department of General Medicine (Endocrinology), Sengkang General Hospital, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore
| | - Julian Thumboo
- SingHealth Regional Health System PULSES Centre, Singapore Health Services, Outram Rd, Singapore, 169608, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,SingHealth Regional Health System, Singapore Health Services, Singapore, Singapore
| | - Lian Leng Low
- SingHealth Regional Health System PULSES Centre, Singapore Health Services, Outram Rd, Singapore, 169608, Singapore. .,SingHealth Regional Health System, Singapore Health Services, Singapore, Singapore. .,Department of Family Medicine and Continuing Care, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore. .,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore. .,Outram Community Hospital, SingHealth Community Hospitals, 10 Hospital Boulevard, Singapore, 168582, Singapore.
| |
Collapse
|
5
|
Majercak KR, Magder LS, Villalonga-Olives E. Social capital and cost-related medication nonadherence (CRN): A retrospective longitudinal cohort study using the Health and Retirement Study data, 2006-2016. SSM Popul Health 2020; 12:100671. [PMID: 33088892 PMCID: PMC7559535 DOI: 10.1016/j.ssmph.2020.100671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 11/17/2022] Open
Abstract
Prescription drug spending and other financial factors (e.g., out-of-pocket costs) partially explain variation in cost-related medication nonadherence (CRN). Indicators of social capital such as neighborhood factors and social support may influence the health and well-being of older adults as they may rely on community resources and support from family and peers to manage conditions. Previous research on the relationship of social capital and CRN has limited evidence and contradictory findings. Hence, our objective is to assess the relationship of social capital indicators (neighborhood social cohesion, neighborhood physical disorder, positive social support, and negative social support) and CRN using a longitudinal design, 2006 to 2016, in a nationally representative sample of older adults in the United States (US). The Health and Retirement Study is a prospective panel study of US adults aged ≥ 50 years evaluated every two years. Data was pooled to create three waves and fitted using Generalized Estimating Equation modelling adjusting for both baseline and timevarying covariates (age, sex, education, race, total household income, and perceived health status). The three waves consisted of 11,791, 12,336, and 9,491 participants. Higher levels of neighborhood social cohesion and positive social support were related with lower CRN (OR 0.92, 95% CI 0.88-0.95 and OR 0.77, 95% CI 0.70-0.84, p<0.01). In contrast, higher levels of neighborhood physical disorder and negative social support were related to higher CRN (OR 1.07, 95% CI 1.03-1.11 and OR 1.46, 95% CI 1.32-1.62, p<0.01). Interventions targeting social capital are needed, reinforcing positive social support and neighborhood social cohesion and diminishing neighborhood physical disorder and negative social support for older adults.
Collapse
Affiliation(s)
- Kayleigh R. Majercak
- University of Maryland Baltimore, School of Pharmacy, Department of Pharmaceutical Health Services Research, 220 Arch Street, 12th Floor, Baltimore, MD 21201, Baltimore, MD, USA
| | - Laurence S. Magder
- University of Maryland Baltimore, School of Medicine, Department of Epidemiology and Public Health, 660 W. Redwood Street, Baltimore, MD 21201, Baltimore, MD, USA
| | - Ester Villalonga-Olives
- University of Maryland Baltimore, School of Pharmacy, Department of Pharmaceutical Health Services Research, 220 Arch Street, 12th Floor, Baltimore, MD 21201, Baltimore, MD, USA
| |
Collapse
|
6
|
Racial and Regional Disparities in Outcomes Among Veterans Initially Adherent to Oral Antidiabetic Therapies: an Observational Cohort Study. J Gen Intern Med 2020; 35:1211-1218. [PMID: 31916211 PMCID: PMC7174452 DOI: 10.1007/s11606-019-05373-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Adherence to prescribed medications is connected with, but is not a guarantee of, improved disease management and health outcomes. It remains unclear whether underlying health disparities exist among patients adherent to therapy and whether differences in outcomes vary by race and residential areas of the country. OBJECTIVE To determine the extent of racial and regional variation in outcomes within 5 years of oral antidiabetic drug initiation among veterans adherent to therapy. DESIGN Retrospective cohort study of 83,265 US Veterans Health Administration data, 2002-2014 PATIENTS: US veterans with uncomplicated diabetes and taking oral antidiabetic agents MAIN MEASURES: Veterans initially adherent to oral antidiabetic therapy were followed for up to 5 years, and comparisons focused on differences between non-Hispanic White and non-Hispanic Black veterans across geographic region and residential type (urban or rural). Outcomes included composite cardiovascular events, composite cerebrovascular events, or all-cause mortality using Poisson and adjusted Cox proportional hazards models. KEY RESULTS Cardiovascular event and all-cause mortality rates differed by race and region, while urban/rural differences were evident for cerebrovascular events and all-cause mortality. For non-Hispanic Blacks, the mortality rate was half that compared to non-Hispanic Whites (6.5 [95% CI 5.8-7.2] versus 13.3 [95% CI 12.9-13.8], p < 0.0001). Compared to the Northeast, all other regions had higher adjusted hazards for cardiovascular or cerebrovascular events (with a single exception), but no regional differences in all-cause mortality were observed. Models with interactions demonstrated that racial differences in cardiovascular events and all-cause mortality were isolated to the Midwest (HR 1.99 [95% CI 1.301-3.06; HR 1.64 [95% CI 1.210-2.215]) and South (HR 1.69 [85% CI 1.347-2.131]; HR 1.27 [95% CI 1.095-1.470]). CONCLUSIONS Despite adherence to therapy, differences in outcomes are likely among veterans with diabetes based on race and geography. Localized analyses may uncover specific social determinants contributing to differences in outcomes.
Collapse
|
7
|
Bauer M, Glenn T, Alda M, Bauer R, Grof P, Marsh W, Monteith S, Munoz R, Rasgon N, Sagduyu K, Whybrow PC. Trajectories of adherence to mood stabilizers in patients with bipolar disorder. Int J Bipolar Disord 2019; 7:19. [PMID: 31482209 PMCID: PMC6722168 DOI: 10.1186/s40345-019-0154-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/24/2019] [Indexed: 01/27/2023] Open
Abstract
Background Nonadherence with mood stabilizers is a major problem that negatively impacts the course of bipolar disorder. Medication adherence is a complex individual behavior, and adherence rates often change over time. This study asked if distinct classes of adherence trajectories with mood stabilizers over time could be found, and if so, which patient characteristics were associated with the classes. Methods This analysis was based on 12 weeks of daily self-reported data from 273 patients with bipolar 1 or II disorder using ChronoRecord computer software. All patients were taking at least one mood stabilizer. The latent class mixed model was used to detect trajectories of adherence based on 12 weekly calculated adherence datapoints per patient. Results Two distinct trajectory classes were found: an adherent class (210 patients; 77%) and a less adherent class (63 patients; 23%). The characteristics associated with the less adherent class were: more time not euthymic (p < 0.001) and female gender (p = 0.016). No other demographic associations were found. Conclusion In a sample of motivated patients who complete daily mood charting, about one quarter were in the less adherent class. Even patients who actively participate in their care, such as by daily mood charting, may be nonadherent. Demographic characteristics may not be useful in assessing individual adherence. Future research on longitudinal adherence patterns in bipolar disorder is needed.
Collapse
Affiliation(s)
- M Bauer
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - T Glenn
- ChronoRecord Association Inc., Fullerton, CA, USA
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - R Bauer
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - P Grof
- Mood Disorders Center of Ottawa, University of Toronto, Toronto, Canada
| | - W Marsh
- Department of Psychiatry, University of Massachusetts, Worcester, MA, USA
| | - S Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - R Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - N Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - K Sagduyu
- Department of Psychiatry, University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
| | - P C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior University of California Los Angeles (UCLA), Los Angeles, CA, USA
| |
Collapse
|
8
|
Pereira MDG, Ferreira G, Machado JC, Pedras S. Beliefs about medicines as mediators in medication adherence in type 2 diabetes. Int J Nurs Pract 2019; 25:e12768. [PMID: 31328394 DOI: 10.1111/ijn.12768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 02/01/2019] [Accepted: 05/29/2019] [Indexed: 12/21/2022]
Abstract
AIMS This study analysed whether beliefs about medicines mediated the relationship between illness representations and medication adherence. BACKGROUND Adherence to medication is required in diabetes treatment, contributing to decreased blood glycaemic levels. The knowledge and perception of patients about diabetes as well as the beliefs about medicines are considered to be key factors for medication adherence. DESIGN The study used a cross-sectional design that included 387 patients recently diagnosed with type 2 diabetes. METHODS Participants were assessed, between 2010 and 2013, and answered the Medication Adherence Scale, the Beliefs about Medicines Questionnaire, and the Brief Illness Perception Questionnaire. RESULTS The results of the path analysis showed that beliefs about medicines had a mediating role on self-report medication adherence with the exception of beliefs about specific concerns with medicines. Therefore, both general beliefs and specific needs about medicines mediated the relationship between diabetes consequences and self-report medication adherence as well as between treatment control and self-report medication adherence. Needs about medicines mediated the relationship between personal control and self-report medication adherence. CONCLUSION Health professionals should target beliefs about medicines besides illness representations regarding medication adherence. The current study may help optimize adherence to medication in early-diagnosed type 2 diabetes patients.
Collapse
Affiliation(s)
| | - Gabriela Ferreira
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - José C Machado
- Institute of Social Sciences, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Susana Pedras
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| |
Collapse
|
9
|
Freeman-Hildreth Y, Aron D, Cola PA, Wang Y. Coping with diabetes: Provider attributes that influence type 2 diabetes adherence. PLoS One 2019; 14:e0214713. [PMID: 30939144 PMCID: PMC6445439 DOI: 10.1371/journal.pone.0214713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 03/19/2019] [Indexed: 12/30/2022] Open
Abstract
Diabetes, a chronic disease affecting over 29 million people in the United States, requires the integration of complex medical tasks into a person's daily life. Patient-centered care and compassion are recognized as essential dimensions of the quality care experience. This research examined provider attributes that influence adherence to type 2 diabetes mellitus (T2DM) regimens and sought to understand the phenomena of provider attributes, treatment adherence, and their relationship to coping ability and treatment outcomes. This quantitative study sampled 474 people with T2DM using a 62-item online survey administered to three different groups. The sample population included people over age 18 diagnosed with T2DM. The first group included 91 persons with T2DM identified through a Facebook group and personal social media connections, the second group included 120 Amazon Mechanical Turk participants with T2DM, and the third group included 263 respondents from a Qualtrics panel who had T2DM. Results indicated that perceived provider compassion (β = .41, ρ < .001) and optimism (β = .48, ρ < .001) positively affected coping ability. Additionally, full mediation effects for self-management were revealed, with coping ability positively mediating the effect of compassion on self-management and the effects of optimism on self-management. Furthermore, full mediation effects were found for treatment satisfaction, with coping ability positively mediating the effect of compassion on treatment satisfaction and the effects of optimism on treatment satisfaction. This research has implications for patients, healthcare professionals, and leaders suggesting that providers who communicate with optimism and compassion positively affect coping ability. As a result, healthcare providers and professionals have an opportunity to enhance self-management adherence by helping their patients cope with the burdens of diabetes. In addition, this study has implications for developing provider communication tools aimed at assessing patients' coping capacity and increasing compassionate communication.
Collapse
Affiliation(s)
| | - David Aron
- Department of Medicine, Case Western Reserve University, Louis Stokes VA Medical Center, Cleveland, Ohio, United States
| | - Philip A. Cola
- Department of Design and Innovation, Weatherhead School of Management, Case Western Reserve University, Cleveland, Ohio, United States
| | - Yunmei Wang
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
| |
Collapse
|
10
|
Hennein R, Hwang SJ, Au R, Levy D, Muntner P, Fox CS, Ma J. Barriers to medication adherence and links to cardiovascular disease risk factor control: the Framingham Heart Study. Intern Med J 2018; 48:414-421. [PMID: 29193523 PMCID: PMC5889324 DOI: 10.1111/imj.13687] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/02/2017] [Accepted: 11/13/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND In the elderly, impaired cognition may weaken medication adherence and compromise treatment for cardiovascular disease (CVD). AIM We examined risk factors for medication adherence and the relationship between adherence and levels of CVD risk factors among older participants with hypertension, dyslipidaemia and diabetes in the Framingham Heart Study. METHODS The four-item Morisky Medication Adherence Scale was administered to 1559 participants, median age 70 years, 53% women. We created an adherence score, ranging from 0 to 4, with low adherence defined as a score ≥2. CVD risk factors were assessed using standard protocols. Cognition was measured using the Mini-Mental State Examination (MMSE) and depressive symptoms were measured using the Center for Epidemiologic Studies of Depression (CES-D) scale. RESULTS Among participants who self-reported taking antihypertensive, lipid-lowering and/or hyperglycaemic medication(s), 12% (n = 191) had low medication adherence. The risk of low adherence increased by 45% (95% confidence interval (CI): 25-68%, P < 0.001) per five-unit increase in CES-D score. In participants taking antihypertensive medication (n = 1017), low adherence was associated with higher mean diastolic blood pressure (73 mmHg, 95% CI: 71-75 vs 71 mmHg, 95% CI: 70-71; P = 0.04) after adjusting for covariates. Among participants taking lipid-lowering medication (n = 937), low adherence was associated with higher mean low-density lipoprotein cholesterol (92 mg/dL, 95% CI: 87-96 vs 86 mg/dL, 95% CI: 84-88; P = 0.03). Low adherence was not associated with fasting plasma glucose (P = 0.10) or haemoglobin A1c (P = 0.68) in the subgroup of participants (n = 192) taking hypoglycaemic medication. CONCLUSIONS Depressive symptoms might act as a barrier for medication adherence, which exacerbates CVD risk factors in older-aged adults.
Collapse
Affiliation(s)
- Rachel Hennein
- Framingham Heart Study, Framingham, Massachusetts, USA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Shih-Jen Hwang
- Framingham Heart Study, Framingham, Massachusetts, USA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Rhoda Au
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Department of Anatomy & Neurobiology, Boston University School of Medicine and Department of Epidemiology, Boston University School of Public Health
| | - Daniel Levy
- Framingham Heart Study, Framingham, Massachusetts, USA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Caroline S. Fox
- Framingham Heart Study, Framingham, Massachusetts, USA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Jiantao Ma
- Framingham Heart Study, Framingham, Massachusetts, USA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
11
|
O'Donnell A, de Vries McClintock HF, Wiebe DJ, Bogner HR. Neighborhood Social Environment and Patterns of Depressive Symptoms Among Patients with Type 2 Diabetes Mellitus. Community Ment Health J 2015; 51:978-86. [PMID: 25761720 PMCID: PMC4567942 DOI: 10.1007/s10597-015-9855-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 02/26/2015] [Indexed: 10/23/2022]
Abstract
This study sought to examine whether neighborhood social environment was related to patterns of depressive symptoms among primary care patients with type 2 diabetes mellitus (DM). Neighborhood social environment was assessed in 179 patients with type 2 DM. Individual patient residential data at baseline was geo-coded at the tract level and was merged with measures of neighborhood social environment. Depressive symptoms at baseline and at 12-week follow up were assessed using the nine-item Patient Health Questionnaire (PHQ-9). Patients in neighborhoods with high social affluence, high residential stability, and high neighborhood advantage were much less likely to have a persistent pattern of depressive symptoms compared to a pattern of few or no depressive symptoms (adjusted odds ratio (OR) = 0.06, 95 % confidence interval (CI) [0.01, 0.36]). Detrimental neighborhood influences may amplify risk for persistent depressive symptoms.
Collapse
Affiliation(s)
- Alison O'Donnell
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Heather F de Vries McClintock
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA.,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, The University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - Douglas J Wiebe
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, The University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - Hillary R Bogner
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA. .,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, The University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA.
| |
Collapse
|
12
|
de Vries McClintock HF, Wiebe DJ, O'Donnell AJ, Morales KH, Small DS, Bogner HR. Neighborhood social environment and patterns of adherence to oral hypoglycemic agents among patients with type 2 diabetes mellitus. FAMILY & COMMUNITY HEALTH 2015; 38:169-79. [PMID: 25739064 PMCID: PMC4351782 DOI: 10.1097/fch.0000000000000069] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
This study examined whether neighborhood social environment was related to patterns of adherence to oral hypoglycemic agents among primary care patients with type 2 diabetes mellitus. Residents in neighborhoods with high social affluence, high residential stability, and high neighborhood advantage, compared to residents in neighborhoods with one or no high features present, were significantly more likely to have an adherent pattern compared to a nonadherent pattern. Neighborhood social environment may influence patterns of adherence. Reliance on a multilevel contextual framework, extending beyond the individual, to promote diabetic self-management activities may be essential for notable public health improvements.
Collapse
Affiliation(s)
- Heather F. de Vries McClintock
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, U.S.A
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, U.S.A
| | - Douglas J. Wiebe
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, U.S.A
| | - Alison J. O'Donnell
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, U.S.A
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, U.S.A
| | - Knashawn H. Morales
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, U.S.A
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, U.S.A
| | - Dylan S. Small
- Department of Statistics, The Wharton School, The University of Pennsylvania, Philadelphia, PA, U.S.A
| | - Hillary R. Bogner
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, U.S.A
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, U.S.A
| |
Collapse
|
13
|
de Vries McClintock HF, Morales KH, Small DS, Bogner HR. A brief adherence intervention that improved glycemic control: mediation by patterns of adherence. J Behav Med 2015; 38:39-47. [PMID: 24913600 PMCID: PMC4262717 DOI: 10.1007/s10865-014-9576-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 05/28/2014] [Indexed: 11/26/2022]
Abstract
This study examined whether longitudinal adherence profiles mediated the relationship between a brief adherence intervention and glycemic control among patients with type 2 diabetes. Adherence was assessed using the Medication Event Monitoring System. Longitudinal analysis via growth curve mixture modeling was carried out to classify patients according to patterns of adherence to oral hypoglycemic agents. Hemoglobin A1c assays were used to measure glycemic control as the clinical outcome. Across the whole sample, longitudinal adherence profiles mediated 35.2% (13.2, 81.0%) of the effect of a brief adherence intervention on glycemic control [from odds ratio (OR) = 8.48, 95% confidence interval (CI) (3.24, 22.2) to 4.00, 95% CI (1.34, 11.93)]. Our results suggest that patients in the intervention had better glycemic control largely due to their greater likelihood of adherence to oral hypoglycemic agents.
Collapse
|