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. 2016 Jun-Jul;48(6):406-20.
doi: 10.1016/j.aprim.2015.09.001. Epub 2016 Jan 13.

[Adherence of Type 2 Diabetes Mellitus approach: Current situation and possible solutions]

[Article in Spanish]
Domingo Orozco-Beltrán  1 , Manel Mata-Cases  2 , Sara Artola  3 , Pedro Conthe  4 , Javier Mediavilla  5 , Carlos Miranda  6
Affiliations

[Adherence of Type 2 Diabetes Mellitus approach: Current situation and possible solutions]

[Article in Spanish]
Domingo Orozco-Beltrán et al. Aten Primaria. 2016 Jun-Jul.

Abstract
in English, Spanish

Objectives: Define the impact and causes of non-adherent type-2 diabetes mellitus (DM2) patients, possible solutions and the role of the different health care professionals involved in the treatment.

Design: Structured questionnaire rating by a two-round Delphi method.

Location: The study was conducted in the Primary Care settings.

Participants: The expert panel consisted of renowned medical professionals with extensive experience in diabetes.

Main measurements: Assessment through a 9-point Likert scale, of the degree of agreement or disagreement on 131 items grouped into 4 blocks: impact; causes of nonadherence; diagnosis of non-adherence, and possible causes, solutions and role of the different professionals involved in adherence.

Results: The participation rate was 76.31%. The primary care health professionals agreed on 110 of the 131 proposals statements (84%), showing agreement on 102 items (77.9%) and disagreement in 8 (6.1%). Consensus was not reached on 21 items.

Conclusions: The lack of adherence of DM2 patients makes the achievement of therapeutic control difficult. The medical practice needs to have specific training and enough resources to reduce the impact of the lack of therapeutic compliance.

Objetivos: Definir el impacto y las causas de la falta de adherencia terapéutica en los pacientes con diabetes mellitus tipo 2 (DM2), las posibles intervenciones para mejorarla y el papel de las distintas partes implicadas.

Diseño: Valoración de cuestionario estructurado mediante método Delphi aplicado en 2 rondas.

Emplazamiento: Estudio realizado en el ámbito de atención primaria.

Participantes: Panel formado por profesionales médicos de reconocido prestigio y con amplia experiencia en diabetes.

Mediciones principales: Valoración a través de una escala Likert de 9 puntos del grado de acuerdo o desacuerdo de 131 ítems agrupados en 4 bloques: impacto; causas de incumplimiento; diagnóstico de la falta de adherencia y de sus posibles causas, y mejores intervenciones y papel de los distintos roles implicados en la mejora de la adherencia.

Resultados: Con una tasa de participación del 76,31%, los profesionales sanitarios de atención primaria consensuaron 110 de las 131 aseveraciones propuestas (84%), mostrando acuerdo en 102 ítems (77,9%) y desacuerdo en 8 (6,1%). No se logró consenso en 21 ítems.

Conclusiones: La falta de adherencia en los pacientes con DM2 dificulta lograr el control terapéutico. La formación específica y disponer de los recursos necesarios en la consulta son esenciales para minimizar el impacto de la falta de adherencia terapéutica.

Keywords: Adherencia terapéutica; Atención primaria; Delphi technique; Diabetes mellitus tipo 2; Diabetes mellitus type 2; Family practice; Medicina de familia; Patient compliance; Primary health care; Técnica Delphi.

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Figures

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Esquema general del estudio:
See this image and copyright information in PMC

References

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