title: Measuring insulin adherence among adults with type 2 diabetes.
abstract: Non-adherence to insulin is common and associated with suboptimal health. We adapted the Morisky Medication Adherence Scale to specify insulin adherence (MIAS) and compared it to the Adherence to Refills and Medication Scale for Diabetes (ARMS-D) and the Summary of Diabetes Self-Care Activities medications subscale (SDSCA-MS) and an insulin-specific (SDSCA-IS) version. A sample of 144 insulin-treated adults (58 % African American/Black, 34 % Caucasian/White, 8 % Other/Mixed race; 6.9 % Hispanic) completed these measures along with a HbA1C test. The internal consistency and factor structure of the MIAS were adequate; 59 % of participants forgot to take insulin and 46 % reported non-adherence. The MIAS was associated with the ARMS-D, SDSCA-MS, and SDSCA-IS (p < 0.001), and higher MIAS scores were marginally associated with better self-rated health (p = 0.057), but significantly associated with fewer emergency room visits (p = 0.001), and better HbA1C (p = 0.001). The MIAS is a valid and reliable insulin adherence assessment tool for practice and research applications.
authors.affiliation: Department of Medicine, Department of Biomedical Informatics, Center for Health and Health Education, Vanderbilt University Medical Center, 2525 West End Ave. Suite 370, Nashville, TN, 37203, USA. chandra.osborn@vanderbilt.edu.
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
authors.affiliation: Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA.|Diabetes Research Center, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Jeffery S
authors.initials: JS
authors.lastname: Gonzalez
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012648:Self Care; D011795:Surveys and Questionnaires
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Insulin therapy; Measurement; Medication adherence; Type 2 diabetes