M B Gomes1, C A Negrato2. 1. Department of Internal Medicine, Diabetes Unit, State University Hospital of Rio de Janeiro, Brazil. 2. Bauru's Diabetics Association, Department of Internal Medicine, Bauru, São Paulo, Brazil. Electronic address: carlosnegrato@uol.com.br.
Abstract
AIMS: Determine the relationship between self-reported adherence to insulin therapeutic regimens in Brazilian patients with type 1 diabetes and demographic, clinical data, glycemic control and cardiovascular risk factors. METHODS: This was a cross-sectional, multicenter study conducted between August 2011 and August 2014 in 10 Brazilian cities. Data were obtained from 1698 patients, aged 30.0±11.90years (55.5% females, 53.6% Caucasians) with a diabetes duration of 15.4±1.9years. Adherence was evaluated using an adapted 4-item Morisky Medication Scale (MMAS) questionnaire. RESULTS: A total of 166 (9.8%), 717 (42.2%) and 815 (48.0%) of the patients reported maximal (group 0), moderate (group 1) and minimal (group 2) adherence to their insulin therapeutic regimen, respectively. A significant difference in HbA1c was observed in patients from group 2, 9.2±2.2% (77±25mmol/mol) compared to group 1, 8.9±2.0% (74±22mmol/mol) and group 0, 8.6±1.9% (71±21mmol/mol) (p=0.003). A multivariate logistic analysis revealed that the significant independent variables related to higher insulin therapeutic regimen adherence were older age, higher adherence to diet, lower rate of self-reported hypoglycemia in the last month, low economic status and living in the Southeast region. Insulin therapeutic regimens, number of daily insulin injections, self-monitoring of blood glucose, gender, ethnicity and cardiovascular risk factors were not related to adherence. CONCLUSIONS: Most Brazilian T1D patients did not adhere to their prescribed insulin therapeutic regimen, according to the MMAS 4-item scale. This tool should be initially used to identify non-adherent patients and help them overcome the barriers to adherence to their prescriptions.
AIMS: Determine the relationship between self-reported adherence to insulin therapeutic regimens in Brazilian patients with type 1 diabetes and demographic, clinical data, glycemic control and cardiovascular risk factors. METHODS: This was a cross-sectional, multicenter study conducted between August 2011 and August 2014 in 10 Brazilian cities. Data were obtained from 1698 patients, aged 30.0±11.90years (55.5% females, 53.6% Caucasians) with a diabetes duration of 15.4±1.9years. Adherence was evaluated using an adapted 4-item Morisky Medication Scale (MMAS) questionnaire. RESULTS: A total of 166 (9.8%), 717 (42.2%) and 815 (48.0%) of the patients reported maximal (group 0), moderate (group 1) and minimal (group 2) adherence to their insulin therapeutic regimen, respectively. A significant difference in HbA1c was observed in patients from group 2, 9.2±2.2% (77±25mmol/mol) compared to group 1, 8.9±2.0% (74±22mmol/mol) and group 0, 8.6±1.9% (71±21mmol/mol) (p=0.003). A multivariate logistic analysis revealed that the significant independent variables related to higher insulin therapeutic regimen adherence were older age, higher adherence to diet, lower rate of self-reported hypoglycemia in the last month, low economic status and living in the Southeast region. Insulin therapeutic regimens, number of daily insulin injections, self-monitoring of blood glucose, gender, ethnicity and cardiovascular risk factors were not related to adherence. CONCLUSIONS: Most Brazilian T1D patients did not adhere to their prescribed insulin therapeutic regimen, according to the MMAS 4-item scale. This tool should be initially used to identify non-adherent patients and help them overcome the barriers to adherence to their prescriptions.
Authors: Gláucia Maria Moraes de Oliveira; Luisa Campos Caldeira Brant; Carisi Anne Polanczyk; Deborah Carvalho Malta; Andreia Biolo; Bruno Ramos Nascimento; Maria de Fatima Marinho de Souza; Andrea Rocha De Lorenzo; Antonio Aurélio de Paiva Fagundes Júnior; Beatriz D Schaan; Fábio Morato de Castilho; Fernando Henpin Yue Cesena; Gabriel Porto Soares; Gesner Francisco Xavier Junior; Jose Augusto Soares Barreto Filho; Luiz Guilherme Passaglia; Marcelo Martins Pinto Filho; M Julia Machline-Carrion; Marcio Sommer Bittencourt; Octavio M Pontes Neto; Paolo Blanco Villela; Renato Azeredo Teixeira; Roney Orismar Sampaio; Thomaz A Gaziano; Pablo Perel; Gregory A Roth; Antonio Luiz Pinho Ribeiro Journal: Arq Bras Cardiol Date: 2022-01 Impact factor: 2.000
Authors: Karla Rezende Guerra Drummond; Fernando Korn Malerbi; Paulo Henrique Morales; Tessa Cerqueira Lemos Mattos; André Araújo Pinheiro; Felipe Mallmann; Ricardo Vessoni Perez; Franz Schubert Lopes Leal; Laura Gomes Nunes de Melo; Marília Brito Gomes Journal: Diabetol Metab Syndr Date: 2018-03-14 Impact factor: 3.320
Authors: Marilia Brito Gomes; Deborah Conte Santos; Marcela H Pizarro; Bianca Senger V Barros; Laura G Nunes de Melo; Carlos A Negrato Journal: Patient Prefer Adherence Date: 2018-01-04 Impact factor: 2.711
Authors: Laura Gomes Nunes Melo; Paulo Henrique Morales; Karla Rezende Guerra Drummond; Deborah Conte Santos; Marcela Haas Pizarro; Bianca Senger Vasconcelos Barros; Tessa Cerqueria Lemos Mattos; André Araújo Pinheiro; Felipe Mallmann; Franz Schubert Lopes Leal; Fernando Korn Malerbi; Marilia Brito Gomes Journal: BMC Public Health Date: 2018-08-08 Impact factor: 3.295