Uncontrolled diabetes mellitus: inertia vs adherence to therapy
DOI:
https://doi.org/10.32385/rpmgf.v39i1.13494Keywords:
Type 2 diabetes, Therapeutics, Therapeutic inertia, Therapeutic complianceAbstract
Background: In Portugal, the rate of non-control of patients with diabetes is around 35%. Among the causes described as barriers to achieving the goals in the control of diabetic patients, therapeutic inertia and therapeutic compliance stand out.
Objectives: Calculate the proportion of patients with uncontrolled diabetes mellitus (DM) at the USF Garcia de Orta and analyze the glycated hemoglobin (HbA1c) values distribution. Calculate the proportion of therapeutic compliance and therapeutic inertia in uncontrolled patients and check for possible associated factors.
Methods: Cross-sectional analytical study. Population: diabetic patients enrolled and monitored at USF Garcia de Orta (N=988). A simple random sample was selected, and calculated for a statistical significance of 0.05, an expected control rate of 40%, and a precision of 4% (n=375).
Results: The sample consisted of 367 diabetic patients with a mean age of 70 years, of which 52% were men. The proportion of patients with uncontrolled DM was 38.1% [95%CI (33.3-43.2%)]. To assess adherence to therapy, the study of the subgroup was used (n=140). It was found that 19.7% [95%CI (13.0-26.5%)] of uncontrolled patients have poor adherence to therapy and this is associated with worse HbA1c values. For therapeutic inertia, the subgroup of patients with two consecutive values of HbA1c ³7% (n=114) was analyzed. The therapeutic inertia was 39.5% [95%CI (33.5-43.2%)], which is lower for higher HbA1c values. Besides HbA1c no association was found between adherence and therapeutic inertia with the other variables studied.
Conclusion: Poor adherence and therapeutic inertia are obstacles to achieving higher control rates in patients with DM.
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