Predicting medication adherence in older Hispanic patients with type 2 diabetes.

Autor: Caballero J; Department of Clinical and Administrative Sciences, College of Pharmacy, Larkin University, Miami, FL jcaballero@ularkin.org., Ownby RL; Department of Psychiatry and Behavioral Medicine, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL., Jacobs RJ; Baylor College of Medicine, Houston, TX., Pandya N; Department of Geriatrics, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL., Hardigan PC; Nova Southeastern University, Fort Lauderdale, FL., Ricabal LC; Department of Pharmacy Practice, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL.
Jazyk: angličtina
Zdroj: American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists [Am J Health Syst Pharm] 2018 May 01; Vol. 75 (9), pp. e194-e201.
DOI: 10.2146/ajhp170067
Abstrakt: 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 (HbA 1c ) 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 HbA 1c 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.
(Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.)
Databáze: MEDLINE
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