Association of psychosocial factors with medication adherence in emerging adults with youth-onset type 2 diabetes: The iCount study.

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2022-12-01 DOI:10.1111/pedi.13431

Paula M Trief, Seth Kalichman, Diane Uschner, Melinda Tung, Kimberly L Drews, Barbara J Anderson, Lida M Fette, Hui Wen, Jane D Bulger, Ruth S Weinstock

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引用次数: 5

Abstract

Aims: To assess associations of psychosocial factors with medication adherence in young adults with youth-onset type 2 diabetes in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) cohort.

Methods: Participants (mean age 26 years) completed validated psychosocial measures. Adherence to oral hypoglycemia agents (OHAs) was assessed with 3-monthly unannounced phone pill counts; insulin adherence by self-report. Logistic and linear regressions identified factors associated with "low-adherence" (<80% of pills/insulin) controlling for confounders.

Results: Of 212 participants taking OHAs (67% female, 39% Hispanic, 36% non-Hispanic Black), 69.8% were low-adherent. After adjustment, beliefs that medicines are necessary was associated with lower odds of low-adherence (p = 0.040, dichotomous). Less self-management support (p = 0.008), no healthcare coverage (p = 0.001), ≥1 (p = 0.008)/≥2 (p = 0.045) need insecurities were associated with higher odds of low-adherence. Factors associated with lower % adherence (continuous) were beliefs that medicines are harmful (p < 0.001)/overused (p = 0.007)/less necessary (p = 0.022), low self-management support (p = 0.003), food insecurity (p = 0.036), no healthcare coverage (p < 0.001), ≥1 (p = 0.003)/≥2 (p = 0.018) need insecurities. Of 192 taking insulin (69% female, 36% Hispanic, 41% non-Hispanic Black, 16% non-Hispanic white), 37.0% were low-adherent. Beliefs that medicines are overused (p = 0.009), that diabetes is not serious (p = 0.010), low diabetes self-efficacy (p = 0.035), high distress (p = 0.027), low self-management support (p = 0.001), food insecurity (p = 0.020), ≥1 (p = 0.011)/≥2 (p = 0.015) insecurities increased odds of insulin low-adherence.

Conclusions: Poor medication adherence, common in young adults with youth-onset type 2 diabetes, is associated with interfering beliefs, diabetes distress and social factors. We must address these factors to develop tailored interventions for this vulnerable group.

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新发2型糖尿病患者的心理社会因素与药物依从性的关系:iCount研究

目的:评估青少年和青年2型糖尿病治疗方案(TODAY2)队列中年轻发病2型糖尿病患者的社会心理因素与药物依从性的关系。方法:参与者(平均年龄26岁)完成有效的心理社会测量。口服降糖药(OHAs)的依从性通过3个月未通知的电话药丸计数进行评估;胰岛素依从性自我报告。Logistic和线性回归确定了与“低依从性”相关的因素(结果:在212名服用OHAs的参与者中(67%为女性，39%为西班牙裔，36%为非西班牙裔黑人)，69.8%为低依从性。调整后，认为药物是必要的与低依从性的几率较低相关(p = 0.040，二分类)。缺乏自我管理支持(p = 0.008)、没有医疗保险(p = 0.001)、≥1 (p = 0.008)/≥2 (p = 0.045)需求不安全感与低依从性的发生率较高相关。与低依从性(持续)相关的因素是认为药物是有害的(p)。结论:药物依从性差，在年轻发病的2型糖尿病患者中很常见，与干扰性信念、糖尿病困扰和社会因素有关。我们必须解决这些因素，为这一弱势群体制定量身定制的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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