Joshua Caballero1, Raymond L Ownby2, Robin J Jacobs3, Naushira Pandya4, Patrick C Hardigan5, Lazara C Ricabal6. 1. Department of Clinical and Administrative Sciences, College of Pharmacy, Larkin University, Miami, FL jcaballero@ularkin.org. 2. Department of Psychiatry and Behavioral Medicine, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL. 3. Baylor College of Medicine, Houston, TX. 4. Department of Geriatrics, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL. 5. Nova Southeastern University, Fort Lauderdale, FL. 6. Department of Pharmacy Practice, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL.
Abstract
PURPOSE: Potential cognitive and demographic correlates of medication nonadherence in older Hispanic adults with type 2 diabetes were investigated. METHODS: Forty community-dwelling participants 65 years of age or older were recruited. Executive control function (ECF) was assessed using the executive clock drawing task (CLOX 1) test and the 25-item Executive Interview. Self-reported medication adherence was measured on a visual analog scale (VAS); measures of glycemic control included glycosylated hemoglobin (HbA1c) concentration. The primary objective was to determine if ECF performance correlated with medication adherence or glycemic control. RESULTS: Participants' mean ± S.D. age was 74.95 ± 7.07 years, and 73% (n = 29) were female. Lower VAS scores correlated with worse CLOX 1 performance (r = 0.38, p = 0.02) and worse HbA1c status (r = -0.42, p = 0.007). Linear regression modeling indicated significant associations between VAS scores and both CLOX 1 results (beta coefficient [β] = 0.41, p = 0.01) and educational level (β = 0.345, p = 0.03). Receiver operating characteristic analysis of CLOX 1 scores (scoring range, 0-15; lower scores indicate greater impairment) showed that a highly sensitive cutoff score for predicting adherence of <90% would be 7, but a cutoff of 10 would provide more specificity. CONCLUSION: Results of an evaluation of a small sample of Hispanic older adults with type 2 diabetes demonstrated a relationship between ECF, as measured by the CLOX 1 instrument, and self-reported medication adherence.
PURPOSE: Potential cognitive and demographic correlates of medication nonadherence in older Hispanic adults with type 2 diabetes were investigated. METHODS: Forty community-dwelling participants 65 years of age or older were recruited. Executive control function (ECF) was assessed using the executive clock drawing task (CLOX 1) test and the 25-item Executive Interview. Self-reported medication adherence was measured on a visual analog scale (VAS); measures of glycemic control included glycosylated hemoglobin (HbA1c) concentration. The primary objective was to determine if ECF performance correlated with medication adherence or glycemic control. RESULTS:Participants' mean ± S.D. age was 74.95 ± 7.07 years, and 73% (n = 29) were female. Lower VAS scores correlated with worse CLOX 1 performance (r = 0.38, p = 0.02) and worse HbA1c status (r = -0.42, p = 0.007). Linear regression modeling indicated significant associations between VAS scores and both CLOX 1 results (beta coefficient [β] = 0.41, p = 0.01) and educational level (β = 0.345, p = 0.03). Receiver operating characteristic analysis of CLOX 1 scores (scoring range, 0-15; lower scores indicate greater impairment) showed that a highly sensitive cutoff score for predicting adherence of <90% would be 7, but a cutoff of 10 would provide more specificity. CONCLUSION: Results of an evaluation of a small sample of Hispanic older adults with type 2 diabetes demonstrated a relationship between ECF, as measured by the CLOX 1 instrument, and self-reported medication adherence.