Adherence of patients with type 2 diabetes mellitus to medications: the role of risk preferences. (1st February 2018)

• Record Type: Journal Article
• Authors: Simon-Tuval, Tzahit; Shmueli, Amir; Harman-Boehm, Ilana
• Is Part Of: Current medical research and opinion. Volume 34:Number 2(2018)
• Page Start: 345
• Page End: 351
• Publication Date: 2018-02-01
• Subjects: Diabetes -- medication -- adherence -- risk preferences; Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1080/03007995.2017.1397506
• Languages: English
• ISSNs: 0300-7995

Abstract

Abstract: Objective: To examine whether risk tolerance is associated with adherence to oral hypoglycemic agents (OHAs). Methods: We performed a cross-sectional study among adult patients with type 2 diabetes mellitus ( n = 308) presenting for routine out-patient visits, using validated questionnaires to estimate: risk preferences (risk-seeking, risk averse, risk neutral), motivation, self-efficacy, impulsivity, perception of the disease and of the interpersonal process of care, demographic and socioeconomic characteristics; computerized patient medical records to estimate disease severity and a computerized database for retrieval of medication adherence, 1 year before the interview. Adherence was estimated using prescription-based measures of proportion of days covered (PDC). Concurrent adherence was calculated as: PDC with ≥1 OHAs; average PDC; PDC of ≥80% for all OHAs. Results: Multivariable ordered logit model revealed that compared to others, risk-seeking patients had lower PDC with ≥1 OHAs ( β = −0.50, p ≤ .1). Specifically, risk-seeking patients were 11.2 percentage points less likely to have ≥80% of the follow-up period covered with ≥1 OHAs available ( p ≤ .1). In addition, risk-seeking patients had lower average PDC ( β = −0.85, p ≤ .05). Specifically, these patients were 19.5 percentage points less likely to have an average PDC of ≥80% ( p ≤ .05). Multivariable logistic model revealed that risk-seeking was associated with lower probability of having PDC ≥80% for all OHAs in the follow-up period (OR; 90% CI: 0.59; 0.35–0.97). Conclusions: Risk-seeking patients are less adherent to OHA medications. Identifying these patients may enable practitioners to proactively tailor strategies to improve their adherence and health outcomes.