The importance of specialist treatment, treatment satisfaction and diabetes education for the compliance of subjects with type 2 diabetes - results from a population-based survey.
OBJECTIVE
This study aims to investigate the degree to which subjects with type 2 diabetes comply with treatment recommendations concerning diet, physical exercise and self-care, the consistency of compliance across different treatment areas, and the association of compliance with individual characteristics of patients and their medical treatment.


METHODS
The sample consists of 345 type 2 diabetes patients who had been drawn from two population-based surveys (MONICA) and from a myocardial infarction registry in Southern Germany, and who have participated in a survey in 1997/98. Data were collected by interviews, questionnaires and medical exams. Pearson correlation and logistic regression analysis were applied to test the relationships. A compliance score was established by adding up the components of the treatment regimen.


RESULTS
Only one fifth of the subjects with type 2 diabetes showed good compliance in terms of the applied score. Compliance was highest in weight measuring and foot care, and poorest in following exercise recommendations, glucose testing, and recording the results. Overall, weak correlations were found between the components of the treatment regimen. Participation in diabetes education, regular consultation of physicians specialized in diabetes care, age (<70 years), and satisfaction with treatment were all associated with better compliance.


CONCLUSIONS
Correlation between the different components of compliance behaviour was low, indicating that compliance should not be measured by one component only. As compliance with the treatment recommendations was poor, education programs for type 2 diabetic subjects should be propagated and the cooperation with diabetes specialists should be promoted.
Arnold-Wörner
N
N
GSF - National Research Center for Environment and Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany.
Holle
R
R
Rathmann
W
W
Mielck
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005260:Female; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012042:Registries; D013038:Specialization; D011795:Surveys and Questionnaires