Keywords
mortality
hospitalization
type 2 diabetes
hypoglycemic agents
How to Cite
Abstract
Introduction: Adherence to medication in patients with diabetes mellitus (DM) is related to a decrease in the fatal outcomes of the disease, the use of medical attention, as well as a reduction in health costs. Non-adherence increases the risk of hospitalizations and mortality from all causes. The frequency of hospitalization due to medical reasons and mortality in these patients is sought.
Materials and methods: 201 patients who participated in the study "Relationship of glycemic control and adherence to pharmacological treatment in adult patients with T2DM from Fundacion Valle del Lili 2016-2017," 187 patients were contacted via telephone. By means of a survey, they were asked about hospitalizations and mortality due to medical causes one year after the measurement of adherence. Descriptive statistical analysis was performed and the most frequent causes of morbidity and death were established.
Results: Of 187 patients surveyed, 41 (21.8%) were hospitalized, 19 (22.4%) were adherent; a stay in ICU was reported in 13 patients (7%), for both the main cause was acute coronary syndrome. The mortality in the two groups was similar and the main cause was the neoplastic etiology. 45.8% of patients did not continue control in the institution, with a slightly higher percentage among non-adherents.
Conclusions: Non-adherence to medication in DM has a high prevalence. The frequency of hospitalization was similar between adherents and non-adherents, however the cause of this differs, with acute coronary syndrome being the main cause in non-adherents, while other causes predominate in the adherents.
References
.GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396: 1204–22. doi.org/10.1016/S0140-6736(20)30925-9
González JC, Walker JH, Einarson TR. Cost-of-illness study of type 2 diabetes mellitus in Colombia. Rev Panam Salud Pública. 2009;26(1):55-63. doi:10.1590/s1020-49892009000700009.
Howard Wild, BS Pharm Rp. The economic rationale for Adherence in the Treatment of Type 2 diabetes mellitus. Reports. 2012;18(3):43-48.
Zare F et al. Health-related quality of life and its associated factors in patients with type 2 diabetes mellitus. SAGE Open Medicine. 2020(8):1-8. doi.org/10.1177/2050312120965314
Holman R et al. 10-Year Follow-up of Intensive Glucose Control in Type 2 Diabetes. N Engl J Med 2008;359:1577-89. Doi: 10.1056/NEJMoa0806470
Jha AK, Aubert RE, Yao J, Teagarden JR, Epstein RS. Greater adherence to diabetes drugs is linked to less hospital use and could save nearly $5 billion annually. Health Aff. 2012;31(8):1836-1846. doi:10.1377/hlthaff.2011.1198
McAdam-Marx C, Bellows BK, Unni S, et al. Determinants of glycaemic control in a practice setting: The role of weight loss and treatment adherence (The DELTA Study). Int J Clin Pract. 2014;68(11):1309-1317. doi:10.1111/ijcp.12502
Krass I, Schieback P, Dhippayom T. Adherence to diabetes medication: A systematic review. Diabet Med. 2015;32(6):725-737. doi:10.1111/dme.12651
Breitscheidel L, Stamenitis S, Dippel F-W, Schöffski O. Economic impact of compliance to treatment with antidiabetes medication in type 2 diabetes mellitus: a review paper. J Med Econ. 2009;13(1):8-15. doi:10.3111/13696990903479199
Asche C, LaFleur J, Conner C. A review of diabetes treatment adherence and the association with clinical and economic outcomes. Clin Ther. 2011;33(1):74-109. doi:10.1016/j.clinthera.2011.01.019
Khunti K, Seidu S, Kunutsor S, Davies M. Association between adherence to pharmacotherapy and outcomes in type 2 diabetes: A meta-analysis. Diabetes Care. 2017;40(11):1588-1596. doi:10.2337/dc16-1925
Guzmán-Gómez GÉ, Arce A, Saavedra H, et al. Adherencia al tratamiento farmacológico y control glucémico en pacientes adultos con diabetes mellitus tipo 2. Alad. 2018;8(1). doi:10.24875/alad.18000319
Kubica A, Kosobucka A, Michalski P, Fabiszak T, Felsmann M. Self-reported questionnaires for assessment adherence to treatment in patients with cardiovascular diseases. Med Res J. 2018;2(4):115-122. doi:10.5603/mrj.2017.0015
Giugliano D, Maiorino MI, Bellastella G, Esposito K. Type 2 diabetes and cardiovascular prevention: the dogmas disputed. Endocrine. 2018;60(2):224-228. doi:10.1007/s12020-017-1418-y
Matthews DR, Tsapas A. Four decades of uncertainty: landmark trials in glycaemic control and cardiovascular outcome in type 2 diabetes. Diabetes Vasc Dis Res 2008;5:216-18. doi:10.3132/dvdr.2008.035.
Mabel Maidana G, Mabel Maidana GI, Lugo GI, et al. Factores que determinan la falta de adherencia de pacientes diabéticos a la terapia medicamentosa. Mem Inst Investig Cienc Salud. 2016;14(1):70-77. doi:10.18004/Mem.iics/1812-9528/2016.014(01)70-077
Delamater D, M A. Improving Patient Adherence. Clinical Diabetes. Clin Diabetes. 2006;24(2). doi:https://doi.org/10.2337/diaclin.24.2.71
Lazo RY; Lores DD. Impact of a pharmaceutical follow-up service implemented in type 2 diabetes mellitus patients. Rev Cubana Farm. 2011;45(2):226-234. https://www.medigraphic.com/pdfs/revcubfar/rcf-2011/rcf112h.pdf
Fornos-Pérez JA, Ferrer JC, García-Rodríguez P, et al. La diabetes en España desde la perspectiva de la farmacia comunitaria: conocimiento, cumplimiento y satisfacción con el tratamiento. Farm Comunitarios. 2017;8(2):5-15. doi:10.5672/fc.2173-9218.(2016/vol8).002.02
Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes—2021. Diabetes Care 2021 Jan; 44(Supplement 1): S53-S72. doi.org/10.2337/dc21-S005.
Asmelash D et al. Knowledge, Attitude, and Practice towards Glycemic Control and Its Associated Factors among Diabetes Mellitus Patients. Journal od Diabetes Research. 2019:1-9. doi.org/10.1155/2019/2593684
Ramos Y, Morejón R, Cabrera Y, Herranz D, Rodriguez W. Adherencia terapéutica, nivel de conocimientos de la enfermedad y autoestima en pacientes diabéticos tipo 2. Gac Médica Espirituana. 2018;20(3):13-23. http://revgmespirituana.sld.cu/index.php/gme/article/view/1498/pdf.
Farr AM, Sheehan JJ, Curkendall SM, Smith DM, Johnston SS, Kalsekar I. Retrospective Analysis of Long-Term Adherence to and Persistence with DPP-4 Inhibitors in US Adults with Type 2 Diabetes Mellitus. Adv Ther. 2014;31(12):1287-1305. doi:10.1007/s12325-014-0171-3
Kim, YY et al. Effect of medication adherence on long-term all-cause-mortality and hospitalization for cardiovascular disease in 65,067 newly diagnosed type 2 diabetes patients. Sci Rep 8, 12190 (2018). https://doi.org/10.1038/s41598-018-30740-y
Currie CJ, Peyrot M, Morgan CL, et al. The impact of treatment non-compliance on mortality in people with type 1 diabetes. J Diabetes Complications. 2013;27(3):219-223. Doi:10.1016/j.jdiacomp.2012.10.006
Gibson TB, Song X, Alemayehu B, et al. Cost sharing, adherence, and health outcomes in patients with diabetes. Am J Manag Care. 2010;16(8):589-600.
Balkhi B et al. Oral antidiabetic medication adherence and glycaemic control among patients with type 2 diabetes mellitus: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia. BMJ Open. 2019; 9(7): e029280. doi: 10.1136/bmjopen-2019-029280.
Feldman BS, Cohen-Stavi CJ, Leibowitz M, et al. Defining the role of medication adherence in poor glycemic control among a general adult population with diabetes. PLoS One. 2014;9(9). doi:10.1371/journal.pone.0108145
Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes—2021. Diabetes Care 2021 Jan; 44(Supplement 1): S40-S52. https://doi.org/10.2337/dc21-S004.
Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes—2021. Diabetes Care 2021 Jan; 44(Supplement 1): S7-S14. https://doi.org/10.2337/dc21-S001
Sabanayagam C, Liew G, Tai ES, et al. Relationship between glycated haemoglobin and microvascular complications: Is there a natural cut-off point for the diagnosis of diabetes? Diabetologia. 2009;52(7):1279-1289. doi:10.1007/s00125-009-1360-5
J.S. H, H.C. K. Relationship between oral antihyperglycemic medication adherence and hospitalization, mortality, and healthcare costs in adult ambulatory care patients with type 2 diabetes in South Korea. Med Care. 2011;49(4):378-384. http://www.embase.com/search/results?subaction=viewrecord%7B&%7Dfrom=export%7B&%7Did=L361619974%5Cnhttp://zp9vv3zm2k.search.serialssolutions.com/?sid=EMBASE%7B&%7Dissn=00257079%7B&%7Did=doi:%7B&%7Datitle=Relationship+between+oral+antihyperglycemic+medicat.
Preis SR, Mph S, Hwang S, et al. Trends in All-Cause and Cardiovascular Disease Mortality among Women and Men with and without Diabetes in the Framingham Heart Study, 1950-2005. Circulation. 2009;119(13):1728-1735. doi:10.1161/CIRCULATIONAHA.108.829176.Trends
Schaan BD, de Figueiredo Neto JA, Moreira LB, et al. Diabetes and cardiovascular events in high-risk patients: Insights from a multicenter registry in a middle-income country. Diabetes Res Clin Pract. 2017;127:275-284. doi:10.1016/j.diabres.2017.03.021
Al-Qerem W et al. Exploring variables associated with medication non-adherence in patients with type 2 diabetes mellitus. PLOS ONE 2021;16(8): e0256666. https://doi.org/10.1371/journal.pone.0256666
Zhu VJ, Tu W, Rosenman MB, Overhage JM. Nonadherence to Oral Antihyperglycemic Agents: Subsequent Hospitalization and Mortality among Patients with Type 2 Diabetes in Clinical Practice. Stud Health Technol Inform. 2015;216:60-63. doi:10.3233/978-1-61499-564-7-60
Tancrendi M et al. Excess Mortality among Persons with Type 2 Diabetes. N Engl J Med 2015; 373:1720-1732. DOI: 10.1056/NEJMoa1504347
Hong, J. S., & Kang, H. C. (2011). Relationship Between Oral Antihyperglycemic Medication Adherence and Hospitalization, Mortality, and Healthcare Costs in Adult Ambulatory Care Patients With Type 2 Diabetes in South Korea. Medical Care, 49(4), 378–384. http://www.jstor.org/stable/41103929
Suárez-Rozo LF, Puerto-García S, Rodríguez-Moreno*, Lina María JR-M. La crisis del sistema de salud colombiano: una aproximación desde la legitimidad y la regulación *. Rev Gerenc Polít Salud. 2017;16:34-50. doi:10.11144/Javeriana.rgps16-32.cssc
Carlos Andrés Merlano-Porras, Louri Gorbanev. Health system in Colombia: a systematic review of literature. Rev Gerenc Polit Salud, Bogotá. 2013;12(24):74-86. http://www.scielo.org.co/pdf/rgps/v12n24/v12n24a05.pdf.
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