Top

Journal of Public Health

Published in:

01-06-2010 | Review Article

Diabetes adherence—does gender matter?

Authors: Sonja Geisel-Marbaise, Harald Stummer

Published in: Journal of Public Health | Issue 3/2010

Abstract

Aim

This paper aims to unobtrusively identify gender patterns in diabetics' adherence to their medication regimen.

Subjects and methods

Non-adherence is a major problem in health care as it affects both the patient’s individual health as well as public health. Seen worldwide, the problem of non-adherence is even more important due to the increasing numbers of the elderly population and of chronic diseases such as diabetes, asthma, HIV, etc. It is estimated that in Germany alone, non-adherence is responsible for costs of €10 billion per year. Finding useful health behaviour patterns could be especially important for the increasing number of patients with chronic diseases such as diabetes, where costs are high and consequences such as retino-, nephro- and neuropathy severe for 180 million diabetics worldwide. This paper analyses the records of two German pharmacies, P1 and P2, regarding gender patterns in adherence to oral antidiabetics as this analysis method has a high specificity. Out of 4,474 (P1) respectively 2,650 (P2) datasets, those were selected that showed the use of medication with oral drugs for diabetes based on ATC code level A10B. The selected medication datasets were fully analysed, also the respective adherence rate for drugs used for hypertension, ATC code level C.

Results

Average adherence rates for oral antidiabetic agents varied, with 25.4% (P1 women) and 34.6% (P1 men), and 27.8% (P2 women) and 26.1% (P2 men). In contrast, average adherence rates with drugs for the cardiovascular system were high, with 73.4% (P1 women) and 74.2% (P1 men), and 57.0% (P2 women) and 70.2% (P2 men).

Conclusion

Adherence rates for oral antidiabetic agents showed no gender patterns. This finding is supported by varying adherence rates for medication for hypertension. In both cases, the chi-square test showed no significant correlation between gender and adherence classification, and also Cramer’s V only showed a small effect of gender on adherence behaviour.

Aalto A, Uutela A (1997) Glycemic control, self-care behaviors, and psychosocial factors among insulin-treated diabetics: A test of an extended health belief model. Int J Behav Med 4(3):191–214CrossRefPubMed

ABDA-Bundesvereinigung Deutsche Apothekerverbände: Non-Compliance kostet 10 Milliarden Euro—Apotheker verbessern Therapietreue. Press release 2007-06-07 Meran/Berlin

ABDA-Bundesvereinigung Deutsche Apothekerverbände: Patienten bevorzugen wohnortnahe Apotheke—Rezeptbelieferung überwiegend am gleichen Tag. Press release 2008-01-21 Berlin

Ahmed AT, Karter AJ, Liu J (2006) Alcohol consumption is inversely associated with adherence to diabetes self-care behaviours. Diabet Med 23:795–802CrossRefPubMed

Andrade SE, Kahler KH, Frech F, Chan KA (2006) Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidemiol Drug Saf 15(8):565–574CrossRefPubMed

Babitsch B (2006) Die Kategorie Geschlecht: Implikationen für den Zusammenhang zwischen sozialer Ungleichheit und Gesundheit. In: Richter M, Hurrelmann K (eds) Gesundheitliche Ungleichheit. Grundlagen, Probleme, Perspektiven, 1st edn. VS Verlag für Sozialwissenschaften, Wiesbaden, pp 271–287

Benecke A (2005) Geschlechtsspezifische Aspekte in der Rehabilitation bei Diabetes mellitus. Pabst, Lengerich

Claxton AJ, Cramer J, Pierce C (2001) A systematic review of the assocations between dose regimens and medication compliance. Clin Ther 23(8):1296–1310CrossRefPubMed

Cosentino M, Leoni O, Banfi F, Lecchini S, Frigo G (2000) An approach for the estimation of drug prescribing using the defined daily dose methodology and drug dispensation data. Eur J Clin Pharmacol 56:513–517CrossRefPubMed

Cramer JA (2004) A systematic review of adherence with medications for diabetes. Diabetes Care 27(5):1218–1224CrossRefPubMed

Davidson MH (2006) Differences between clinical trial efficacy and real-world effectiveness. Am J Manag Care 12(15):405–411

Dezii CM, Kawabata H, Tran M (2002) Effect of once-daily and twice-daily dosing on adherence with prescribed glipizide oral therapy for type 2 diabetes. South Med J 95(1):68–71PubMed

Dunn SM, Turtle JR (1981) The myth of the diabetic personality. Diabetes Care 4(6):640–646PubMed

Fairley CK, Permana A, Read T (2005) Long-term utility of measuring adherence by self-report compared with pharmacy record in a routine clinic setting. HIV Med 6:366–369CrossRefPubMed

Farmer KC (1999) Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practise. Clin Ther 21(6):1074–1090CrossRefPubMed

Fincham JE (2007) Patient compliance with medications. Issues and opportunities. Pharmaceutical Products Press, Binghamton New York

Fitzgerald JT, Anderson RM, Davis WK (1995) Gender differences in diabetes attitudes and adherence. Diabetes Educ 21:523–529CrossRefPubMed

Gerlinger T (2006) Historische Entwicklung und theoretische Perspektiven der Gesundheitssoziologie. In: Wendt C, Wolf C (eds) Soziologie der Gesundheit. VS Verlag für Sozialwissenschaften, Wiesbaden, pp 34–56

Guénette L, Moisan J, Préville M, Boyer R (2005) Measures of adherence based self-report exhibited poor agreement with those based on pharmacy records. J Clin Epidemiol 58:924–933CrossRefPubMed

Häussler B (2006) Weißbuch diabetes in Deutschland: Bestandsaufnahme und Zukunftsperspektiven der Versorgung einer Volkskrankheit. Thieme, Stuttgart

Hearnshaw H, Lindenmeyer A (2005) What do we mean by adherence to treatment and advice for living with diabetes? A review of literature on definitions and measurements. Diabet Med 23:720–728CrossRef

Heuer H, Heuer SH, Lennecke K (1999) Compliance in der Arzneitherapie: Von der Non-Compliance zu pharmazeutischer und medizinischer Kooperation. Wissenschaftliche Verlagsgesellschaft mbH, Stuttgart

Horne R (1999) Patients' beliefs about treatment: the hidden determinant of treatment outcome? J Psychosom Res 47:491–495CrossRefPubMed

Hughes DA, Walley T (2003) Predicting "real world" effectiveness by integrating adherence with pharmacodynamic modeling. Clin Pharmacol Ther 74(1):1–8CrossRefPubMed

Icks A (2005) Diabetes mellitus. Gesundheitsberichterstattung des Bundes, 24, Robert Koch-Institute, Berlin

Jungbauer-Gans M (2006) Soziale und kulturelle Einflüsse auf Krankheit und Gesundheit. In: Wendt C, Wolf C (eds) Soziologie der Gesundheit. VS Verlag für Sozialwissenschaften, Wiesbaden, pp 86–108

Jungbauer-Gans M, Gross C (2006) Gesundheitliche Ungleichheit. Grundlagen, Probleme, Perspektiven. In: Richter M, Hurrelmann K (eds) Gesundheitliche Ungleichheit. Grundlagen, Probleme, Perspektiven, 1st edn. VS Verlag für Sozialwissenschaften, Wiesbaden, pp 73–89

Krueger KP, Berger BA, Felkey B (2005) Medication adherence and persistence: A comprehensive review. Adv Ther 22(4):313–356CrossRefPubMed

Lai JCL, Cheng S (2004) Health beliefs, optimism, and health-related decisions: A study with Hong Kong Chinese. Int. J Psychol 39(3):179–189CrossRef

Lange C, Ziese T (2007) Gesundheit in Deutschland. 2. edn. Robert-Koch-Institute (ed) Gesundheitsberichterstattung des Bundes, Berlin

Maty SC, Lynch JW, Raghunathan TE, Kaplan GA (2008) Childhood socioeconomic position, gender, adult body mass index, and incidence of type 2 diabetes mellitus over 34 years in the Alameda County Study. Am J Public Health 98(8):1486–1494CrossRefPubMed

Max Rubner-Institut, Karlsruhe (ed) (2008) Nationale Verzehrsstudie II, Ergebnisbericht, Teil 1 Die bundesweite Befragung zur Ernährung von Jugendlichen und Erwachsenen

Navuluri RB (2000) Gender differences in the factors related to physical activity among adults with diabetes. Nurs Health Sci 2:191–199CrossRef

Renneberg B, Hammelstein P (2006) Gesundheitspsychologie. Heidelberg, Springer MedizinCrossRef

Revicki DA, Frank L (1999) Pharmacoeconomic evaluation in the real world—effectiveness versus efficacy studies. Pharmacoeconomics 15(5):423–434CrossRefPubMed

Reymond J, Lennecke K, Marty S (2003) Compliance. In: Jaehde U, Radziwill R, Mühlebach S, Schunack W (eds) Lehrbuch der Klinischen Pharmazie, 2nd edn. Wissenschaftliche Verlagsgesellschaft mbH, Stuttgart, pp 241–253

Rickles NM, Svarstad BL (2007) Relationship between multiple self-reported nonadherence measures and pharmacy records. Res Social Adm Pharm 3(4):363–377PubMed

Robert-Koch-Institute (ed) (2006) Health in Germany. Federal Health Reporting, Berlin

Robiner WN, Yozwiak JA, Bearman DL, Strand TD, Strasburg KR (2009) Barriers to clinical research participation in a diabetes randomized clinical trial. Soc Sci Med 68(6):1069–1074CrossRefPubMed

Ross S, Grant A, Counsell C, Gillespie W, Russell I, Prescott R (1999) Barriers to participation in randomised controlled trials: a systematic review. J Clin Epidemiol 52(12):1143–1156CrossRefPubMed

Sabaté E (2005) Adherence to long-term therapies: evidence for action. World Health Organization (WHO), Geneva

Schoen C, Osborn R, Huynh PT, Doty MM, Fenley JA (November 2005) The Commonwealth Fund 2005 International Health Policy Survey of Sicker Adults in Six Countries. (Commonwealth Fund pub. no. 871) The Commonwealth Fund, New York

Schwabe U, Paffrath D (2008) Arzneiverordnungs-Report 2007-Aktuelle Daten, Kosten. Trends und Kommentare, Springer Medizin, Berlin, Heidelberg

Schwarzer R (2004) Psychologie des Gesundheitsverhaltens—Einführung in die Gesundheitspsychologie, 3rd edn. Hogrefe, Göttingen

Shah NR, Hirsch AG, Zacke C, Taylor S, Wood GC, Stewart WF (2009) Factors associated with first-fill adherence rates for diabetic medications: A cohort study. J Gen Intern Med 24(2):233–237CrossRefPubMed

Steiner JF, Prochazka AV (1997) The assessment of refill compliance using pharmacy records: Methods, validity, and applications. J Clin Epidemiol 50(1):105–116CrossRefPubMed

Vedhara K, Wadsworth E, Norman P, Searle A, Mitchell J, Macrae N et al (2004) Habitual prospective memory in elderly patients with type 2 diabetes: implications for medication adherence. Psychol Health Med 9(1):17–27CrossRef

Vermeire E, Hearnshaw H, Van Royen P, Denekens J (2001) Patient adherence to treatment: three decades of research. A comprehensive overview. J Clin Pharm Ther 26(5):331–342CrossRefPubMed

Vrijens B, Tousset E, Rode R, Bertz R, Mayer S, Urquhart J (2005) Successful projection of the time course of drug concentration in plasma during a 1-year period from electronically compiled dosing-time data used as input to individually parameterized pharmacokinetic models. J Clin Pharmacol 45(4):461–467CrossRefPubMed

Wolf C, Wendt C (2006) Perspektiven der Gesundheitssoziologie. In: Wendt C, Wolf C (eds) Soziologie der Gesundheit. VS Verlag für Sozialwissenschaften, Wiesbaden, pp 9–33

World Health Organization (WHO) (ed) (September 2006) Fact Sheet Diabetes. (Fact Sheet WHO, 312). World Health Organization (WHO), Geneva

Title: Diabetes adherence—does gender matter?
Authors: Sonja Geisel-Marbaise
Harald Stummer
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: Journal of Public Health / Issue 3/2010
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-009-0305-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diabetes adherence—does gender matter?

Abstract

Aim

Subjects and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Subjects and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2010

Editorial

Johannes Hartig, Eckhard Klieme, Detlev Leutner (eds): Assessment of Competencies in Educational Contexts

Geographic variation in invasive cardiac procedure rates in New South Wales, Australia

Environmental risk factors affecting transmission of Helicobacter pylori infection in Egypt

The fraction of disability pensions attributable to smoking and obesity. Results from a 15-year follow-up study

Teaching evaluation of the Master of Health Policy and Management program at the Centre School of Public Health, School of Medicine, Belgrade University