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

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation Pub Date : 2024-06-05 DOI:10.1111/jdi.14228

Juliana CN Chan, Jean Claude Mbanya, Jean-Marc Chantelot, Marina Shestakova, Ambady Ramachandran, Hasan Ilkova, Lucille Deplante, Melissa Rollot, Lydie Melas-Melt, Juan Jose Gagliardino, Pablo Aschner

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Abstract

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.

Abstract Image

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使用自然语言处理的 2 型糖尿病患者报告结果和治疗依从性：国际糖尿病管理实践观察研究第 8 波。

目的/简介：我们分析了 2 型糖尿病患者的患者报告结果，以更好地了解有助于坚持治疗的看法和经验：在正在进行的国际糖尿病管理实践研究中，我们从结构化问卷（慢性治疗接受度问卷和糖尿病自我管理问卷）和开放式问题的自由文本答案中收集了患者报告的结果数据，以评估对治疗价值和副作用的看法，以及坚持治疗和自我管理的障碍和促进因素。自由文本答案通过自然语言处理进行分析：2018-2020 年，我们招募了 2475 名 2 型糖尿病患者（43.3% 接受过胰岛素治疗，糖化血红蛋白（HbA1c）为 8.0 ± 1.8%；30.9% HbA1c 为 1c（7.9 ± 1.8% vs 8.3 ± 1.9%，P 1c 结论：患者的认知/体验会影响治疗依从性和自我管理。以患者为中心的教育和支持计划应考虑患者报告的结果，旨在提高患者的能力并培养新的生活习惯，从而改善血糖控制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Investigation ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

9.40%

发文量

218

审稿时长

6-12 weeks

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).