Relationship of Depression and Diabetes Self-Care, Medication Adherence, and Preventive Care

DOI PDF 被引用文献9件
  • Elizabeth H.B. Lin
    Center for Health Studies, Group Health Cooperative, Seattle, Washington
  • Wayne Katon
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
  • Michael Von Korff
    Center for Health Studies, Group Health Cooperative, Seattle, Washington
  • Carolyn Rutter
    Center for Health Studies, Group Health Cooperative, Seattle, Washington
  • Greg E. Simon
    Center for Health Studies, Group Health Cooperative, Seattle, Washington
  • Malia Oliver
    Center for Health Studies, Group Health Cooperative, Seattle, Washington
  • Paul Ciechanowski
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
  • Evette J. Ludman
    Center for Health Studies, Group Health Cooperative, Seattle, Washington
  • Terry Bush
    Center for Health Studies, Group Health Cooperative, Seattle, Washington
  • Bessie Young
    Department of Medicine, Veterans Administration Hospital, University of Washington, Seattle, Washington

書誌事項

公開日
2004-09-01
DOI
  • 10.2337/diacare.27.9.2154
公開者
American Diabetes Association

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説明

<jats:p>OBJECTIVE—We assessed whether diabetes self-care, medication adherence, and use of preventive services were associated with depressive illness.</jats:p> <jats:p>RESEARCH DESIGN AND METHODS—In a large health maintenance organization, 4,463 patients with diabetes completed a questionnaire assessing self-care, diabetes monitoring, and depression. Automated diagnostic, laboratory, and pharmacy data were used to assess glycemic control, medication adherence, and preventive services.</jats:p> <jats:p>RESULTS—This predominantly type 2 diabetic population had a mean HbA1c level of 7.8 ± 1.6%. Three-quarters of the patients received hypoglycemic agents (oral or insulin) and reported at least weekly self-monitoring of glucose and foot checks. The mean number of HbA1c tests was 2.2 ± 1.3 per year and was only slightly higher among patients with poorly controlled diabetes. Almost one-half (48.9%) had a BMI &gt;30 kg/m2, and 47.8% of patients exercised once a week or less. Pharmacy refill data showed a 19.5% nonadherence rate to oral hypoglycemic medicines (mean 67.4 ± 74.1 days) in the prior year. Major depression was associated with less physical activity, unhealthy diet, and lower adherence to oral hypoglycemic, antihypertensive, and lipid-lowering medications. In contrast, preventive care of diabetes, including home-glucose tests, foot checks, screening for microalbuminuria, and retinopathy was similar among depressed and nondepressed patients.</jats:p> <jats:p>CONCLUSIONS—In a primary care population, diabetes self-care was suboptimal across a continuum from home-based activities, such as healthy eating, exercise, and medication adherence, to use of preventive care. Major depression was mainly associated with patient-initiated behaviors that are difficult to maintain (e.g., exercise, diet, medication adherence) but not with preventive services for diabetes.</jats:p>

収録刊行物

  • Diabetes Care

    Diabetes Care 27 (9), 2154-2160, 2004-09-01

    American Diabetes Association

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