Date of Award

2004

Degree Type

Dissertation

First Advisor

Cynthia Willey Temkin

Abstract

Diabetes is a prevalent, chronic disease and it affects more than 16 million Americans. Strict adherence to a prescribed medication regimen has been identified as an essential factor that may delay, slow or prevent early development of diabetes related comorbidities. The objective of this research project was to document the prevalence of self-reported medication adherence in a large population of patients with diabetes and to explore the association between self-reported medication adherence and: (a) methods of administration of prescribed hypoglycemic medication among patients with type 2 diabetes treated with insulin or pills; (b) length of time since diagnosis among patients with type 2 diabetes on insulin treatment since diagnosis; (c) dosing frequency of prescribed medication among patients with type 2 diabetes treated with oral hypoglycemic medication. The study participants were identified from the research database about diabetes self management created by LifeScan, a subsidiary of Johnson & Johnson. Data collection occurred during 1994 from mailed questionnaires to 2,800 individuals with diabetes. Overall response rate was 73.4%. The total study sample included 2,056 individuals with self-reported diagnoses of diabetes. The mean self-reported medication adherence during the past week among insulin users was 83.9%, almost the same as among the participants treated with oral hypoglycemic medication, the mean adherence was 83.8%. Treatment mode did not show statistically significant association with self-reported medication adherence but three factors, "age", "race" and "number of routine doctor's office visits" were significantly associated with medication adherence. Further, the study participants treated with insulin for 5 years or less since their diagnosis were significantly more likely to be adherent with the prescribed insulin treatment. Also, participants older then 60 years of age were almost twice more likely to adhere to prescribed treatment than participants younger then 60 years. The mean medication adherence among participants on once-a-day dosing of was 94.9% while the mean adherence among participants on twice-a-day dosing was 85.5%. Study participants using oral hypoglycemic medication once-a-day were significantly more likely to be adherent to the prescribed treatment than those using their hypoglycemic medication twice-a-day.

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