Ágnes Vincze1, Antónia Losonczi2 , Beatrix A. Domján1, Ádám Gy. Tabák1, Adrienne Stauder3
1Semmelweis Unversity, Ist Dep. of Internal Medicine, Budapest
2Eötvös Lorand University, Faculty of Education and Psychology, Budapest
3Semmelweis University, Institute of Behavioural Sciences, Budapest
Patient adherence: can we trust the physicians’ evaluation?
Ágnes Vincze , Antónia Losonczi , Beatrix A. Domján, Ádám Gy. Tabák, Adrienne Stauder
Introduction: To establish the psychosocial determinants of adherence in type 2 diabetes, it is essential that we reliably measure adherence behaviour.
Aims: To describe the relationship between self-reported patient cooperation, an objective measure of patient adherence based on target driven laboratory data and physicians’ estimates of patient adherence. A further aim is to determine which of these entities predicts best patients’ de facto treatment fidelity.
Method: Adherence behaviour data were obtained via 1) self-administered questionnaires (the 8-item Morisky Medication Adherence Scale, MMAS-8; the Diabetes Self-Management Questionnaire, DSMQ); 2) objective measures based on laboratory: glycated haemoglobin (HbA1c), 3) values derived from LDL-cholesterol levels and statin therapy; and 4) doctors’ evaluation (blind to laboratory data) on a 0-10 visual analogue scale concerning patient adherence. Pearson’s correlation coefficients were computed for detecting relationships between variables, and linear regression analyses were performed for testing predictive power.
Results: Altogether 150 type 2 diabetic subjects (85 outpatient and 65 inpatient) participated in the study. MMAS-8 and DSMQ total scores were not related to HbA1c or lipid values. One of the 4 subscales of DSMQ (‘Health-Care Use’) was correlated to HbA1c (-0,25, p<0.05). Physicians’ evaluation correlated with DSMQ score (r=0.32; p<0.05), HbA1c values (r= -0.226; p<0.05), and lipid values (r=0.35; p<0.05). Physicians’ evaluation was related to HbA1c and lipid values even after controlling for age, gender and body mass index.
Conclusion: Physicians’ evaluation was a better indicator of patient adherence than patients’ subjective measure of self-management when compared with objective measures of adherence based on laboratory and treatment data. Our results draw the attention that further analysis is needed to determine on which impressions and considerations are based the doctor’s evaluation.
Keywords: adherence, type 2 diabetes, adherence measurement
Doctoral School: Semmelweis University, Mental Health Studies
Program: Mental Health Sciences
Supervisor: Adrienne Stauder
E-mail address: email@example.com