Barry W Rovner1, Robin J Casten2. 1. Department of Neurology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA; Department of Psychiatry, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA; Department of Ophthalmology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA. Electronic address: barry.rovner@jefferson.edu. 2. Department of Psychiatry and Human Behavior, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.
Abstract
OBJECTIVES: To evaluate determinants of medication adherence and glycemic control in black patients with diabetes and mild cognitive impairment (MCI). METHODS: Cross-sectional study of 143 participants with mean age of 68.8 (SD: 6.7) years; 66.4% were women. RESULTS: Eighty-seven participants (60.8%) self-reported medication nonadherence; they had more negative beliefs about medicines, greater diabetes-related distress, and more difficulty with daily living activities and affording medications than adherent participants. There were no group differences in cognition, depressive symptoms, or glycemic control. Glycemic control negatively correlated with regimen distress, emotional burden, interpersonal distress, beliefs that physicians overprescribe medications, and beliefs that medications are harmful. CONCLUSIONS: Beliefs about medications, diabetes-related distress, functional disability, and medication affordability are associated with medication nonadherence in black individuals with diabetes and MCI. Interventions that respect personal health beliefs and compensate for impaired cognition may improve medication adherence and glycemic control in this population.
OBJECTIVES: To evaluate determinants of medication adherence and glycemic control in black patients with diabetes and mild cognitive impairment (MCI). METHODS: Cross-sectional study of 143 participants with mean age of 68.8 (SD: 6.7) years; 66.4% were women. RESULTS: Eighty-seven participants (60.8%) self-reported medication nonadherence; they had more negative beliefs about medicines, greater diabetes-related distress, and more difficulty with daily living activities and affording medications than adherent participants. There were no group differences in cognition, depressive symptoms, or glycemic control. Glycemic control negatively correlated with regimen distress, emotional burden, interpersonal distress, beliefs that physicians overprescribe medications, and beliefs that medications are harmful. CONCLUSIONS: Beliefs about medications, diabetes-related distress, functional disability, and medication affordability are associated with medication nonadherence in black individuals with diabetes and MCI. Interventions that respect personal health beliefs and compensate for impaired cognition may improve medication adherence and glycemic control in this population.
Authors: Barry W Rovner; Robin J Casten; Catherine Verrier Piersol; Neva White; Megan Kelley; Benjamin E Leiby Journal: J Am Geriatr Soc Date: 2020-02-11 Impact factor: 5.562