A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences
Abstract Background Although diabetes is one of the fastest increasing diseases in prevalence worldwide and demands significant medical resources, more than half of all patients with diabetes do not achieve the expected target level of blood glucose. As a potential cause of poor glycemic control, in...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-06-01
|
| Series: | BMC Endocrine Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12902-021-00778-7 |
| _version_ | 1819025206012805120 |
|---|---|
| author | Yoshiko Tominaga Donald E. Morisky Mayumi Mochizuki |
| author_facet | Yoshiko Tominaga Donald E. Morisky Mayumi Mochizuki |
| author_sort | Yoshiko Tominaga |
| collection | DOAJ |
| description | Abstract Background Although diabetes is one of the fastest increasing diseases in prevalence worldwide and demands significant medical resources, more than half of all patients with diabetes do not achieve the expected target level of blood glucose. As a potential cause of poor glycemic control, insufficient adherence to medication has long been discussed and variably studied. However, dropout from treatment as another plausible cause has not been fully examined. The aim of this study was to clarify profiles of patients with diabetes who discontinued pharmacotherapy (Discont group) by extracting reasons of their decisions and by comparing with those who continued (Cont group) in terms of the related factors to glycemic control. Methods A cross-sectional, internet-based survey was conducted among Japanese with diabetes registered in a database. A self-administered questionnaire consisting of the 8-item version of the Morisky Medication Adherence Scale (MMAS-8), glycosylated haemoglobin (HbA1c) level, and demographic and disease characteristics was completed by all participants. Reasons for medication discontinuation and resumption were also received retrospectively from participants in the Discont group. To examine the risk of uncontrolled HbA1c, logistic regression analysis was conducted in each group. Results In the Discont group (148 cases), older age at resumption of pharmacotherapy and current smoking habit increased the probability of uncontrolled HbA1c, whereas in the Cont group (146 cases), a familial history of diabetes and better medication adherence in MMAS-8 scores decreased the probability of uncontrolled HbA1c. A relationship between medication adherence and HbA1c level was seen in the Cont but not in the Discont group. About 70 % of those in the Discont group made their decision to terminate diabetes treatment without consulting physicians and half of them perceived their situations inappropriately. Conclusions Those who discontinued pharmacotherapy were less adherent to medication than those who did not discontinue. Risk factors for glycemic control also differed between those who discontinued and those who did not. More than one-third of participants with diabetes who discontinued pharmacotherapy had inappropriate perceptions of their disease, which medical professionals should be aware of for better interventions. |
| first_indexed | 2024-12-21T05:06:59Z |
| format | Article |
| id | doaj.art-fd36da3e84c245aaae76446dc9edaed9 |
| institution | Directory Open Access Journal |
| issn | 1472-6823 |
| language | English |
| last_indexed | 2024-12-21T05:06:59Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Endocrine Disorders |
| spelling | doaj.art-fd36da3e84c245aaae76446dc9edaed92022-12-21T19:15:08ZengBMCBMC Endocrine Disorders1472-68232021-06-012111810.1186/s12902-021-00778-7A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequencesYoshiko Tominaga0Donald E. Morisky1Mayumi Mochizuki2Social Pharmacy, Faculty of Pharmaceutical Sciences, Niigata University of Pharmacy and Applied Life ScienceDepartment of Community Health Sciences, UCLA Fielding School of Public HealthDivision of Hospital Pharmacy Science, Faculty of Pharmacy, Keio UniversityAbstract Background Although diabetes is one of the fastest increasing diseases in prevalence worldwide and demands significant medical resources, more than half of all patients with diabetes do not achieve the expected target level of blood glucose. As a potential cause of poor glycemic control, insufficient adherence to medication has long been discussed and variably studied. However, dropout from treatment as another plausible cause has not been fully examined. The aim of this study was to clarify profiles of patients with diabetes who discontinued pharmacotherapy (Discont group) by extracting reasons of their decisions and by comparing with those who continued (Cont group) in terms of the related factors to glycemic control. Methods A cross-sectional, internet-based survey was conducted among Japanese with diabetes registered in a database. A self-administered questionnaire consisting of the 8-item version of the Morisky Medication Adherence Scale (MMAS-8), glycosylated haemoglobin (HbA1c) level, and demographic and disease characteristics was completed by all participants. Reasons for medication discontinuation and resumption were also received retrospectively from participants in the Discont group. To examine the risk of uncontrolled HbA1c, logistic regression analysis was conducted in each group. Results In the Discont group (148 cases), older age at resumption of pharmacotherapy and current smoking habit increased the probability of uncontrolled HbA1c, whereas in the Cont group (146 cases), a familial history of diabetes and better medication adherence in MMAS-8 scores decreased the probability of uncontrolled HbA1c. A relationship between medication adherence and HbA1c level was seen in the Cont but not in the Discont group. About 70 % of those in the Discont group made their decision to terminate diabetes treatment without consulting physicians and half of them perceived their situations inappropriately. Conclusions Those who discontinued pharmacotherapy were less adherent to medication than those who did not discontinue. Risk factors for glycemic control also differed between those who discontinued and those who did not. More than one-third of participants with diabetes who discontinued pharmacotherapy had inappropriate perceptions of their disease, which medical professionals should be aware of for better interventions.https://doi.org/10.1186/s12902-021-00778-7diabetesdiscontinuationadherencepersistencedisease perception |
| spellingShingle | Yoshiko Tominaga Donald E. Morisky Mayumi Mochizuki A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences BMC Endocrine Disorders diabetes discontinuation adherence persistence disease perception |
| title | A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences |
| title_full | A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences |
| title_fullStr | A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences |
| title_full_unstemmed | A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences |
| title_short | A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences |
| title_sort | cross sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy reasons and consequences |
| topic | diabetes discontinuation adherence persistence disease perception |
| url | https://doi.org/10.1186/s12902-021-00778-7 |
| work_keys_str_mv | AT yoshikotominaga acrosssectionalstudyclarifyingprofilesofpatientswithdiabeteswhodiscontinuedpharmacotherapyreasonsandconsequences AT donaldemorisky acrosssectionalstudyclarifyingprofilesofpatientswithdiabeteswhodiscontinuedpharmacotherapyreasonsandconsequences AT mayumimochizuki acrosssectionalstudyclarifyingprofilesofpatientswithdiabeteswhodiscontinuedpharmacotherapyreasonsandconsequences AT yoshikotominaga crosssectionalstudyclarifyingprofilesofpatientswithdiabeteswhodiscontinuedpharmacotherapyreasonsandconsequences AT donaldemorisky crosssectionalstudyclarifyingprofilesofpatientswithdiabeteswhodiscontinuedpharmacotherapyreasonsandconsequences AT mayumimochizuki crosssectionalstudyclarifyingprofilesofpatientswithdiabeteswhodiscontinuedpharmacotherapyreasonsandconsequences |