Racial/ethnic differences in concerns about current and future medications among patients with type 2 diabetes.
OBJECTIVE
To evaluate ethnic differences in medication concerns (e.g., side effects and costs) that may contribute to ethnic differences in the adoption of and adherence to type 2 diabetes treatments.


METHODS
We conducted face-to-face interviews from May 2004 to May 2006 with type 2 diabetic patients > or =18 years of age (N = 676; 25% Latino, 34% non-Hispanic Caucasian, and 41% non-Hispanic African American) attending Chicago-area clinics. Primary outcomes of interest were concerns regarding medications and willingness to take additional medications.


RESULTS
Latinos and African Americans had higher A1C levels than Caucasians (7.69 and 7.54% vs. 7.18%, respectively; P < 0.01). Latinos and African Americans were more likely than Caucasians to worry about drug side effects (66 and 49% vs. 39%, respectively) and medication dependency (65 and 52% vs. 39%, respectively; both P < 0.01). Ethnic minorities were also more likely to report reluctance to adding medications to their regimen (Latino 12%, African American 18%, and Caucasian 7%; P < 0.01). In analyses adjusted for demographics, income, education, and diabetes duration, current report of pain/discomfort with pills (odds ratio 2.43 [95% CI 1.39-4.27]), concern regarding disruption of daily routine (1.97 [1.14-3.42]), and African American ethnicity (2.48 [1.32-4.69]) emerged as major predictors of expressed reluctance to adding medications.


CONCLUSIONS
Latinos and African Americans had significantly more concerns regarding the quality-of-life effects of diabetes-related medications than Caucasians. Whether these medication concerns contribute significantly to differences in treatment adoption and disparities in care deserves further exploration.
Huang
Elbert S
ES
Section of General Internal Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA. ehuang@medicine.bsd.uchicago.edu
Brown
Sydney E S
SE
Thakur
Nidhi
N
Carlisle
Lisabeth
L
Foley
Edward
E
Ewigman
Bernard
B
Meltzer
David O
DO
D000328:Adult; D001294:Attitude to Health; D044383:Black People; D002641:Chicago; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D004358:Drug Therapy / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006630:Hispanic or Latino; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007407:Interviews as Topic; D010349:Patient Compliance; D011237:Predictive Value of Tests; D011788:Quality of Life; D044465:White People; D055815:Young Adult; D001741:Black or African American
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents