Diabetes Care:抑郁状态对糖尿病药物治疗的依从性有什么影响?

2016-10-18 MedSci MedSci原创

我们对情绪困扰进行了全面的评估,并检查了随着时间的推移,情绪困扰与糖尿病药物治疗依从性之间的关系。 种族和社会经济背景多样的2型糖尿病患者完成了经过验证的关于糖尿病苦恼和抑郁的自我报告(SRs),提供了血液样本,检测了A1C。在随后的3个月时间里,对104例2型糖尿病患者的服药依从性进行了电子监控(EM)。使用分层线性回归分析,评估糖尿病苦恼和抑郁对依从性的影响。 EM组和SR组参与者

我们对情绪困扰进行了全面的评估,并检查了随着时间的推移,情绪困扰与糖尿病药物治疗依从性之间的关系。

种族和社会经济背景多样的2型糖尿病患者完成了经过验证的关于糖尿病苦恼和抑郁的自我报告(SRs),提供了血液样本,检测了A1C。在随后的3个月时间里,对104例2型糖尿病患者的服药依从性进行了电子监控(EM)。使用分层线性回归分析,评估糖尿病苦恼和抑郁对依从性的影响。

EM组和SR组参与者3个月的平均± SD服药依从性分别为76.1% ± 25.7%和83.7% ± 21.9%。更高水平SR(P < 0.001)和访谈为主(P < 0.05)抑郁症状的严重程度(P < 0.05)和糖尿病相关苦恼(P < 0.01)与EM和SR的依从性呈显著的二元关系。回归模型显示,基线糖尿病苦恼是随访过程中的重要的独立预测因子:EM (β = −0.29; P = 0.001),SR (β = −0.24; P < 0.02)。SR抑郁是EM和SR依从性的独立预测因素,可以让糖尿病苦恼的影响降低到不再具有显著意义。随后的模型表明,这种影响是由躯体,而不是认知情感症状相关的抑郁。对于访谈为基础的抑郁症状也有相同的结论,但是强度更弱。

研究结果表明,糖尿病相关的苦恼和抑郁症状状的严重程度,是2型糖尿病患者不依从药物治疗的危险因素。研究识别的抑郁症状属于躯体症状,与认知情感症状无关。情绪与药物依从性之间的潜在联系还需要进一步研究。

原始出处:


Jeffrey S. Gonzalez,et al.Tangled up in Blue: Unraveling the Links Between Emotional Distress and Treatment Adherence in Type 2 Diabetes.Diabetes Care 2016 Oct;

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    2016-10-20 fyxzlh
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