Trajectories of antidiabetic medication adherence in older adults and the effect of depression and anxiety symptoms.

IF 3.7 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Giraud Ekanmian, Carlotta Lunghi, Helen-Maria Vasiliadis, Line Guénette
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Abstract

Objectives: Common mental health disorders, such as anxiety and depression, significantly impact medication adherence in various chronic conditions. However, few studies have captured the evolving nature of adherence behavior, indicating a need for further investigation. The objectives were to describe adherence trajectories to antidiabetic medications among older patients and to explore the potential association between these trajectories and the presence of anxiety and depression.

Methods: We conducted a secondary analysis of the ESA-S study involving 282 elderly participants who were prevalent users of antidiabetic medications. Medication adherence was measured using claims data over a 12-month period. Group-Based Trajectory Modeling (GBTM) was employed to identify distinct adherence trajectories. The association between the presence of common mental health disorders, assessed using self-reported symptoms and diagnostic codes from medico-administrative data, and adherence trajectories was estimated through multinomial logistic regressions.

Results: Four distinct adherence trajectories were identified and defined as low adherence (6.7%), fair adherence (18.1%), high adherence (37.9%), and nearly perfect adherence (37.2%). These patterns were also stable during the 12-month follow-up period. No significant association was found between common mental health disorders and medication adherence trajectories in this cohort, even after adjusting for potential confounders.

Conclusion: Older patients with diabetes mostly depicted high adherence. Depression or anxiety did not impact adherence trajectories. However, our study was underpowered to detect small to moderate effects of these common mental health disorders.

老年人抗糖尿病药物依从性的轨迹及抑郁和焦虑症状的影响
目的:常见的精神健康障碍,如焦虑和抑郁,显著影响各种慢性疾病的药物依从性。然而,很少有研究捕捉到依从性行为的演变性质,这表明需要进一步的调查。目的是描述老年患者对抗糖尿病药物的依从性轨迹,并探索这些轨迹与焦虑和抑郁存在之间的潜在关联。方法:我们对ESA-S研究进行了二次分析,涉及282名普遍使用抗糖尿病药物的老年人。使用12个月期间的索赔数据来衡量药物依从性。采用基于群体的轨迹模型(GBTM)识别不同的依从性轨迹。使用自我报告的症状和来自医疗管理数据的诊断代码评估常见精神健康障碍的存在与依从性轨迹之间的关联,通过多项逻辑回归估计。结果:四种不同的依从性轨迹被确定并定义为低依从性(6.7%),一般依从性(18.1%),高依从性(37.9%)和近乎完美的依从性(37.2%)。这些模式在12个月的随访期间也很稳定。在这个队列中,即使在调整了潜在的混杂因素后,也没有发现常见精神健康障碍和药物依从性轨迹之间的显著关联。结论:老年糖尿病患者大多表现为高依从性。抑郁或焦虑对依从性轨迹没有影响。然而,我们的研究在检测这些常见精神健康障碍的小到中度影响方面能力不足。
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来源期刊
Endocrine Practice
Endocrine Practice ENDOCRINOLOGY & METABOLISM-
CiteScore
7.60
自引率
2.40%
发文量
546
审稿时长
41 days
期刊介绍: Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.
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