F López-Simarro1, I Moral2, A Aguado-Jodar3, C Cols-Sagarra4, J Mancera-Romero5, M Alonso-Fernández6, S Miravet-Jiménez7, C Brotons2. 1. Medicina de Familia, ABS Martorell Urbano. Institut Català de la Salut, Martorell, Barcelona, España. Electronic address: flopez.cp.ics@gencat.cat. 2. Unidad de Investigación, Equipo de Atención Primaria Sardenya. Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, España. 3. CAP Sagrada Familia, Consorci Sanitari Integral, Barcelona, España. 4. Medicina de Familia, ABS Martorell Rural, Martorell, Barcelona, España. 5. Medicina de Familia, Centro de Salud Ciudad Jardín, Málaga, España. 6. Medicina de Familia, Centro de Salud de La Eria, Oviedo, España. 7. Medicina de Familia, ABS Martorell Urbano. Institut Català de la Salut, Martorell, Barcelona, España.
Abstract
OBJECTIVE: The purpose of this study was to analyse both the impact of low therapeutic adherence (TA) and therapeutic inertia (TI) on poor blood glucose control and on risk factors for heart disease in patients with DM2. MATERIAL AND METHODS: A cross-sectional study was conducted in a Primary Halth Care centre. A total of 320 patients with DM2 were included and an assessment was made of control goals (HbA1c≤7%, blood pressure ≤130/80mmHg, and LDL-cholesterol≤100mg/dl). A pharmacy retrieval <80% was considered as a lack of TA and the non-modification of treatment in badly controlled patient as TI. RESULTS: The percentage of patients with good control of HbA1c, blood pressure and LDL-cholesterol was 62.5%, 40.9%, and 35.9%, respectively. Lower figures of TA were present in poorly controlled patients, and TI was not found to be related to TA. In the patients with poor HbA1c control, 25.8% had TI, 24.8% poor TA, and 11.9% had both of them. As regards LDL-cholesterol, 3.6% presented poor TA, 70.4% showed TI, and 16% with poor TA and TI (P<.001). As for blood pressure, 3.5% of patients had poor TA, 54.6% had TI, and 21.5% of them had poor TA as well as TI (P<.01). CONCLUSIONS: Lack of therapeutic adherence and therapeutic inertia were found in a high percentage of poorly-controlled DM2 patients with bad control. Therapeutic inertia was found to be of great relevance in this study.
OBJECTIVE: The purpose of this study was to analyse both the impact of low therapeutic adherence (TA) and therapeutic inertia (TI) on poor blood glucose control and on risk factors for heart disease in patients with DM2. MATERIAL AND METHODS: A cross-sectional study was conducted in a Primary Halth Care centre. A total of 320 patients with DM2 were included and an assessment was made of control goals (HbA1c≤7%, blood pressure ≤130/80mmHg, and LDL-cholesterol≤100mg/dl). A pharmacy retrieval <80% was considered as a lack of TA and the non-modification of treatment in badly controlled patient as TI. RESULTS: The percentage of patients with good control of HbA1c, blood pressure and LDL-cholesterol was 62.5%, 40.9%, and 35.9%, respectively. Lower figures of TA were present in poorly controlled patients, and TI was not found to be related to TA. In the patients with poor HbA1c control, 25.8% had TI, 24.8% poor TA, and 11.9% had both of them. As regards LDL-cholesterol, 3.6% presented poor TA, 70.4% showed TI, and 16% with poor TA and TI (P<.001). As for blood pressure, 3.5% of patients had poor TA, 54.6% had TI, and 21.5% of them had poor TA as well as TI (P<.01). CONCLUSIONS: Lack of therapeutic adherence and therapeutic inertia were found in a high percentage of poorly-controlled DM2 patients with bad control. Therapeutic inertia was found to be of great relevance in this study.
Keywords:
Adherencia terapéutica; Atención primaria de salud; Clinic practice patterns; Diabetes mellitus tipo 2; Diabetes mellitus type 2; Intensificación; Intensification; Medication adherence; Perfiles de práctica clínica; Primary care