Effect of Medicine Adherence on the Occurrence of Cerebrovascular Disorders in Diabetes Mellitus Patients
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OBJECTIVES: To assess the association between the occurrence of cerebrovascular disorders and a medication adherence in diabetes mellitus patients. METHODS: Medical records from 1,114 new patients with diabetes mellitus were collected and the occurrence of cerebrovascular disorders was observed. Data was gathered from the health examination records of diabetes mellitus patients registered at the Korean Metabolic Syndrome Research from 1996 to 2005, medication records from the National Health Insurance Corporation and death data from the National Statistics Office from 1997 to 2007. Hazard ratios were analyzed using the Cox proportional hazard model to test the association between the occurrence of cerebrovascular disorders and the level of medication adherence. Medication adherence was calculated using Continuous measure of Medication Acquisition (CMA). RESULTS: Of 1,114 diabetes mellitus patients, cerebrovascular disorders occurred in 67 cases (6.1%). The mean duration for the development of a cerebrovascular disorder was 3.82 yr. Medication adherence (≥0.8 vs. <0.5: HR, 3.26; 95% CI, 1.47-7.21, ≥0.8 vs. 0.5-0.7 HR, 0.99; 95% CI, 0.33-2.95) was an independent factor associated with the occurrence of cerebrovascular disorders in diabetes mellitus. CONCLUSION: Increased medication adherence is necessary to prevent the occurrence of cerebrovascular disorders in diabetes mellitus patients. Furthermore we propose that CMA be considered as a method for monitoring medication adherence in clinics.
Abstract
OBJECTIVES: To assess the association between the occurrence of cerebrovascular disorders and a medication adherence in diabetes mellitus patients. METHODS: Medical records from 1,114 new patients with diabetes mellitus were collected and the occurrence of cerebrovascular disorders was observed. Data was gathered from the health examination records of diabetes mellitus patients registered at the Korean Metabolic Syndrome Research from 1996 to 2005, medication records from the National Health Insurance Corporation and death data from the National Statistics Office from 1997 to 2007. Hazard ratios were analyzed using the Cox proportional hazard model to test the association between the occurrence of cerebrovascular disorders and the level of medication adherence. Medication adherence was calculated using Continuous measure of Medication Acquisition (CMA). RESULTS: Of 1,114 diabetes mellitus patients, cerebrovascular disorders occurred in 67 cases (6.1%). The mean duration for the development of a cerebrovascular disorder was 3.82 yr. Medication adherence (≥0.8 vs. <0.5: HR, 3.26; 95% CI, 1.47-7.21, ≥0.8 vs. 0.5-0.7 HR, 0.99; 95% CI, 0.33-2.95) was an independent factor associated with the occurrence of cerebrovascular disorders in diabetes mellitus. CONCLUSION: Increased medication adherence is necessary to prevent the occurrence of cerebrovascular disorders in diabetes mellitus patients. Furthermore we propose that CMA be considered as a method for monitoring medication adherence in clinics.
참고문헌 (17)
- "Korean statistical information service; statistics for cause of death/from:"[URL]
- Smith WS, "Cerebrovascular disease, In Harrison’s principles of internal medicine. 17th ed", pp.2513~2535 (2008), Mc Graw Hill
- Ministry of Health and Welfare Korea Center for Disease Control and Prevention, "2008 Statistics for Health: The Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV)", pp.52~53 (2009)
- Steiner JF, "The assessment of refill compliance using pharmacy records: methods, validity, and applications", J Clin Epidemiol, 50, pp.105~116 (1997)
- Chobanian AV, "Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report", JAMA, 289, pp.2560~2672 (2003)
- Stevens RJ, "Risk factors for myocardial infarction case fatality and stroke case fatality in type 2 diabetes: UKPDS 66", Diabetes Care, 27, pp.201~207 (2004)
- Stratton IM, "Association of glycaemia with macrovascular and microvascular complication of type 2 diabetes (UKPDS 35): prospective observational study", BMJ, 321, pp.405~412 (2000)
- Wilcox R, "Effects of pioglitazone in patients with type 2 diabetes with or without previous stroke: results from PROactive (PROspective pioglitAzone Clinical Trial in macro Vascular Events 04)", Stroke, 38, pp.865~873 (2007)
- Hier DB, "Stroke recurrence within 2 years after ischemic infarction", Stroke, 22, pp.155~161 (1991)
- Sacco RL, "Determinants of early recurrence of cerebral infarction, The Stroke Data Bank", Stroke, 20, pp.983~989 (1989)
- Wolf PA, "Probability of stroke: a risk profile from the Framingham Study", Stroke, 22, pp.312~318 (1991)
- Burchfiel CM, "Glucose intolerance and 22-year stroke Incidence. The Honolulu Heart Program", Stroke, 25, pp.951~957 (1994)
- Whisnant JP, "A population-based model of risk factors for ischemic stroke: Rochester, Minnesota", Neurology, 47, pp.1420~1428 (1996)
- Jørgensen H, "Stroke in patients with diabetes. The Copenhagen Stroke Study", Stroke, 25, pp.1977~1984 (1994)
- Alter M, "Stroke recurrence in diabetics: Does control of blood glucose reduce risk", Stroke, 28, pp.1153~1157 (1997)
- Idris I, "Diabetes mellitus and stroke", Int J Clin Pract, 60, pp.48~56 (2006)
- A report on a project for chronic disease care in Ulsan, 2006, "Ulsan metropolitan city, Inje university", 56~ (2006)