제2형 당뇨병 환자의 약물 치료 순응도와 연관된 요인
Factors Associated with Compliance Using Diamicron in Patients with Type 2 Diabetes
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초록
연구배경: 당뇨병과 같은 만성 질환의 치료에 중요한 요인은 순응도이다. 당뇨 진단 후 처음 약물 치료를 하는 환자에서의 치료 순응도를 알아보고, 이와 관련된 요인을 알아보고자 다기관 추적 관찰 연구를 하였다. 방법: 2006년 3월부터 2007년 12월까지 8개 병원 가정의학과에서 제2형 당뇨병으로 처음 진단되었거나 기존의 혈당 강하제 복용자 중 최근 4주 이상 복용 중단한 환자 326명을 대상으로 자료를 수집하였고, 체질량 지수 및 공복혈당, 당화혈색소, 혈중 지질 농도 검사 시행 후 경구 혈당강하제를 처방하였다. 약물 치료 12주 후 약물 투여 상황및 치료 반응에 따라 순응군과 비순응군으로 분류하여 이에 연관된 요인들을 분석하였다. 결과: 총 참여자 326명 중 순응군은 243명(74.5%)이었다. 나이, 성별을 보정하여 로지스틱 회귀분석을 시행하였을 때, 병용 약물이 있는 경우(odd ratio [OR], 2.03; 95%confidence interval [CI], 1.04-3.97), 당뇨병 관련 영양교육을 받았던 경우(OR, 2.08; 95% CI, 1.08-4.03) 순응도가 높았다(P<0.05). 결론: 경구혈당강하제 복용의 단기 순응도는 74.5%로병용 약물을 복용하는 환자 및 영양 교육을 받은 환자들에서 순응도가 높게 나타났다.
Abstract
Background: Diabetes mellitus (DM) is one of the most important chronic diseases in public health, thus optimal management of this condition is crucial. For this purpose, oral hypoglycemic agents (OHA) are commonly prescribed with their consistent use being mandatory to maintain adequate blood glucose levels. We aimed to evaluate the compliance with OHA in patients with DM, and to determine the factors associated with compliance. Methods: From March 2006 to December 2007, we enrolled patients with type 2 DM who were newly diagnosed or had discontinued OHAs for more than four weeks. For OHA, diamicron was prescribed to the participants and response to medication was evaluated by physicians after 12 weeks. Compliance was defined as patients taking diamicron continuously or stopping the medication due to well-controlled blood sugar levels. Demographic characteristics, anthropometric measurements, fasting glucose, and lipid profiles were collected and analyzed. Results: The mean age of our 326 subjects was 56.0±9.9 years and 74.5% was defined to be compliant. Logistic regression analysis adjusting for age and sex revealed that combined medication use (odd ratio [OR],2.03; 95% confidence interval [CI], 1.04-3.97) and diabetes-related nutritional education (OR, 2.08; 95% CI,1.08-4.03) (P<0.05) were factors associated with compliance with OHA. Conclusions: About three quarters of the DM patients in our study, using diamicron for the first time, showed compliance after 12 weeks of treatment. Concomitant medications and diabetes-related nutrition education were associated with compliance.
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