Patient-reported outcomes and treatment adherence in type 2 diabetes using natural language processing: Wave 8 of the Observational International Diabetes Management Practices Study.

Autor:	Chan JC; Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China., Mbanya JC; Doctoral School of Life Sciences, Health and Environment, and Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon., Chantelot JM; Sanofi, Paris, France., Shestakova M; Endocrinology Research Center, Moscow, Russia., Ramachandran A; India Diabetes Research Foundation, Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India., Ilkova H; Istanbul University, Istanbul, Turkey., Deplante L; Quinten Health, Paris, France., Rollot M; Quinten Health, Paris, France., Melas-Melt L; IVIDATA Life Sciences, Levallois-Perret, France., Gagliardino JJ; CENEXA (UNLP-CONICET-Ce As CICPBA), School of Medicine UNLP, La Plata, Argentina., Aschner P; Javeriana University School of Medicine and San Ignacio University Hospital, Bogotá, Colombia.
Jazyk:	angličtina
Zdroj:	Journal of diabetes investigation [J Diabetes Investig] 2024 Sep; Vol. 15 (9), pp. 1306-1316. Date of Electronic Publication: 2024 Jun 05.
DOI:	10.1111/jdi.14228
Abstrakt:	Aims/introduction: We analyzed patient-reported outcomes of people with type 2 diabetes to better understand perceptions and experiences contributing to treatment adherence. Materials and Methods: In the ongoing International Diabetes Management Practices Study, we collected patient-reported outcomes data from structured questionnaires (chronic treatment acceptance questionnaire and Diabetes Self-Management Questionnaire) and free-text answers to open-ended questions to assess perceptions of treatment value and side-effects, as well as barriers to, and enablers for, adherence and self-management. Free-text answers were analyzed by natural language processing. Results: In 2018-2020, we recruited 2,475 patients with type 2 diabetes (43.3% insulin-treated, glycated hemoglobin (HbA 1c ) 8.0 ± 1.8%; 30.9% with HbA 1c  <7%) from 13 countries across Africa, the Middle East, Europe, Latin America and Asia. Mean ± standard deviation scores of chronic treatment acceptance questionnaire (acceptance of medication, rated out of 100) and Diabetes Self-Management Questionnaire (self-management, rated out of 10) were 87.8 ± 24.5 and 3.3 ± 0.9, respectively. Based on free-text analysis and coded responses, one in three patients reported treatment non-adherence. Overall, although most patients accepted treatment values and side-effects, self-management was suboptimal. Treatment duration, regimen complexity and disruption of daily routines were major barriers to adherence, whereas habit formation was a key enabler. Treatment-adherent patients were older (60 ± 11.6 vs 55 ± 11.7 years, P < 0.001), and more likely to have longer disease duration (12 ± 8.6 vs 10 ± 7.7 years, P < 0.001), exposure to diabetes education (73.1% vs 67.8%, P < 0.05), lower HbA 1c (7.9 ± 1.8% vs 8.3 ± 1.9%, P < 0.001) and attainment of HbA 1c  <7% (29.7% vs 23.3%, P < 0.01). Conclusions: Patient perceptions/experiences influence treatment adherence and self-management. Patient-centered education and support programs that consider patient-reported outcomes aimed at promoting empowerment and developing new routines might improve glycemic control. (© 2024 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)
Databáze:	MEDLINE
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