제2형 당뇨병 환자의 치료에서 복약순응도가 혈당 조절에 미치는 영향
Medication Adherence : Evaluation and Impact on Glycemic Control in Type 2 Diabetes Mellitus
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As known in clinical trial like DCCT, UKPDS, tight glycemic control is essential to prevent complications from diabetes mellitus(DM). In type 2 diabetes taking multiple medication, nonadherence to medications is common problem. The aim of our study is to investigate adherence rate of patients with type 2 DM and to evaluate association between many factors including adherence rate and HbA1C. 441 patients with type 2 DM who visited Busan National University Hospital endocrine internal department from Aug 13 to Sep 2, 2008 (3weeks) were enrolled. We conducted a man-to-man questionnaire survey about general knowledge about diabetes mellitus, medicine and adherence, and measured HbA1C. Among them, 305 patients taking oral hypoglycemic agent(OHA) were analyzed to investigate correlation between adherence rate and glycemic control. We studied 305 patients (male 126, female 179, average age 61.2±9.8 years, DM duration 8.6±6.4 years, average adherence 88.8±16.2%, average HbA1C 7.03±1.18%). HbA1C showed significant relation with DM duration (r=0.137, p=0.017), number of OHA in regimen (r=0.135, p=0.018), dosage frequency (r=0.132, p=0.026), Medication Refill Adherence(MRA)(r=-0.124, p=0.030) and adherence(r=-0.168, p=0.003). Adherence had significant relation with MRA(r=0.148, p=0.010) but didn't have statical corelationship with DM duration, number of OHA and dosage frequency. Patients that their adherence rate exceed 90% took fewer OHA (p=0.011) and went on a better dietary treatment (p=0.007). In patients controlling diabetes mellitus with OHA, when adherence rate and MRA was higher, HbA1C was lower. As a result, to improve adherence rate, it is necessary to enhance patient education, do careful consideration about prescription medicine number and dosage frequency.
Abstract
As known in clinical trial like DCCT, UKPDS, tight glycemic control is essential to prevent complications from diabetes mellitus(DM). In type 2 diabetes taking multiple medication, nonadherence to medications is common problem. The aim of our study is to investigate adherence rate of patients with type 2 DM and to evaluate association between many factors including adherence rate and HbA1C. 441 patients with type 2 DM who visited Busan National University Hospital endocrine internal department from Aug 13 to Sep 2, 2008 (3weeks) were enrolled. We conducted a man-to-man questionnaire survey about general knowledge about diabetes mellitus, medicine and adherence, and measured HbA1C. Among them, 305 patients taking oral hypoglycemic agent(OHA) were analyzed to investigate correlation between adherence rate and glycemic control. We studied 305 patients (male 126, female 179, average age 61.2±9.8 years, DM duration 8.6±6.4 years, average adherence 88.8±16.2%, average HbA1C 7.03±1.18%). HbA1C showed significant relation with DM duration (r=0.137, p=0.017), number of OHA in regimen (r=0.135, p=0.018), dosage frequency (r=0.132, p=0.026), Medication Refill Adherence(MRA)(r=-0.124, p=0.030) and adherence(r=-0.168, p=0.003). Adherence had significant relation with MRA(r=0.148, p=0.010) but didn't have statical corelationship with DM duration, number of OHA and dosage frequency. Patients that their adherence rate exceed 90% took fewer OHA (p=0.011) and went on a better dietary treatment (p=0.007). In patients controlling diabetes mellitus with OHA, when adherence rate and MRA was higher, HbA1C was lower. As a result, to improve adherence rate, it is necessary to enhance patient education, do careful consideration about prescription medicine number and dosage frequency.
참고문헌 (15)
- "KDA(Korean Diabetes Association)", ~
- "UKPDS(United Kingdom Prospective Diabetes Study)", ~
- "DCCT(Diabetes control and complications trial)", ~
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