title: Interplay between Oral Hypoglycemic Medication Adherence and Quality of Life among Elderly Type 2 Diabetes Mellitus Patients.
abstract: BACKGROUND
  Adherence to medications is an important factor that contributes to therapeutic success. With the current increase in the elderly population, information relating to adherence to treatment and quality of life (QoL) of diabetic elderly patients will help the healthcare provider to improve their treatment. Thus, this study aims to determine the factors affecting adherence to medications and the consequence of non adherence to QoL.
  
  
  METHODS
  This was a cross-sectional study using validated Morisky Medication Adherence Scale (MMAS) Questionnaire. This study was conducted to assess the level of adherence on oral hypoglycemic medications (OHM) and quality of life of the Type 2 diabetes mellitus (T2DM) elderly patients in an urban health centre in Malaysia. A retrospective medication record review was also conducted to collect and confirm data on patients' demographics, diagnosis, treatments, and outcomes.
  
  
  RESULTS
  One hundred and seventy nine patients were recruited in this study. Median adherence score was 7.75 (IQR 6.50- 8.00). Good adherer was observed in 48.00% of the participants. A Chi-square test indicated significant correlation between adherence and HbA1c (p= 0.010). The mean elderly diabetes mellitus Problem Areas in Diabetes (PAID) score was 6.30 ±SD 8.50. A significant inversed association was observed between PAID score and the level of adherence (r = - 0.175, p< 0.05). A highly significant difference in the low adherence group (p = 0.002). PAID score significantly correlated with age (years), female gender and HbA1c (p <0.05). A negative association between HbA1c levels and adherence was identified where a 1% increase in HbA1c was associated with a 30% decrease in the likelihood of being adherent.
  
  
  CONCLUSIONS
  A medication adherence rate of 48% was obtained among elderly T2DM patients treated in the primary care clinic. This study showed that HbA1c is a relevant tool to assess patient glycemic control and adherence. Sociodemographic characteristics were not statistically significantly associated with adherence. We reported a negative correlation between adherence and T2DM related emotional distress. The identified factors that relieve emotional distress of the elderly T2DM patients are similar with the western countries.
authors: Professor, Faculty of Pharmacy, Universiti Teknologi MARA , Puncak Alam, Malaysia .
authors: Mohamed Mansor
authors: MM
authors: Manan
authors: Master Graduate, Faculty of Pharmacy, Universiti Teknologi MARA , Puncak Alam, Malaysia .
authors: Akhma Radzuanna
authors: AR
authors: Husin
authors: Senior Clinical Pharmacist, College of Pharmacy, Qassim University , Buraidah, Saudi Arabia; Senior Clinical Pharmacist, College of Pharmacy, Qassim University, Buraidah, Saudi Arabia; Researcher, Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Malaysia .
authors: Ali Saleh
authors: AS
authors: Alkhoshaiban
authors: Assistant Professor, Pharmacy Practice Department, College of Pharmacy, Qassim University , Buraidah, Saudi Arabia .
authors: Yaser Mohammed Ali
authors: YM
authors: Al-Worafi
authors: Senior Lecturer, Faculty of Pharmacy, Universiti Teknologi MARA; Clinical and Social Research Group, Brain and Neuroscience Communities of Research, Universiti Teknologi MARA, Shah Alam, Malaysia .
authors: Long Chiau
authors: LC
authors: Ming
keywords: HbA1c; Malaysia; Morisky medication adherence scale; PAID score and public health care
references: Diabet Med. 2003 Jan;20(1):69-72
references: 12519323
references: BMC Public Health. 2008 Feb 22;8:70
references: 18294380
references: Int J Clin Pharm. 2011 Dec;33(6):1028-35
references: 22083724
references: South Med Rev. 2011 Dec;4(2):102-3
references: 23093890
references: Med J Malaysia. 1999 Jun;54(2):192-9
references: 10972029
references: Med J Malaysia. 2006 Oct;61(4):397-8
references: 17243514
references: Diabetes Care. 1995 Jun;18(6):754-60
references: 7555499
references: Int J Obes Relat Metab Disord. 2000 Sep;24 Suppl 3:S12-20
references: 11063280
references: Asia Pac J Public Health. 2015 Mar;27(2):NP580-9
references: 23536235
references: Pharmacotherapy. 2013 Aug;33(8):798-811
references: 23649849
references: Med J Malaysia. 2010 Sep;65(3):180-6
references: 21939164
references: Diabetes Care. 1997 May;20(5):760-6
references: 9135939
references: Ann Pharmacother. 2004 Feb;38(2):303-12
references: 14742770
references: Inflamm Bowel Dis. 2011 Feb;17(2):599-604
references: 20848512
references: Int J Hypertens. 2013;2013:409083
references: 23573413
references: Health Expect. 2006 Mar;9(1):25-36
references: 16436159
references: J Clin Hypertens (Greenwich). 2008 May;10(5):348-54
references: 18453793
references: Diabetes Care. 2004 May;27(5):1218-24
references: 15111553
references: Patient Prefer Adherence. 2013 Jun 17;7:525-30
references: 23814461
references: Diabetes Educ. 2005 Mar-Apr;31(2):240-50
references: 15797853
references: J Nurs Scholarsh. 2003;35(3):207
references: 14562485
references: Diabetes Care. 2000 Sep;23(9):1305-9
references: 10977023
references: Lancet Diabetes Endocrinol. 2014 Jan;2(1):56-64
references: 24622669
references: Diabetologia. 2006 Jul;49(7):1489-97
references: 16752167
references: J Ren Care. 2013 Dec;39(4):222-7
references: 24152068
references: Diabetes Res Clin Pract. 2010 Nov;90(2):216-21
references: 20832888
references: Diabetes Metab. 2006 Dec;32(6):611-6
references: 17296515
references: J Psychosom Res. 2011 Feb;70(2):155-60
references: 21262418
references: Med Care. 2004 Mar;42(3):200-9
references: 15076819
references: JAMA. 2002 Jul 24-31;288(4):455-61
references: 12132975
references: Arch Med Res. 2005 May-Jun;36(3):300-6
references: 15925020