Are people with schizophrenia adherent to diabetes medication? A comparative meta-analysis

PSYCHIATRY RESEARCH

卷:250

Review

Gorczynski, Paul¹  Firth, Joseph²  Stubbs, Brendon^3,4  Rosenbaum, Simon⁵  Vancampfort, Davy^6,7 

[1] Univ Portsmouth, Dept Sport & Exercise Sci, Spinnaker Bldg,Cambridge Rd, Portsmouth PO1 2UP, Hants, England

[2] Univ Manchester, Inst Brain Behaviour & Mental Hlth, Manchester M13 9PL, Lancs, England

[3] South London & Maudsley NHS Fdn Trust, Physiotherapy Dept, London SE5 8AZ, England

[4] Kings Coll London, Inst Psychiat Psychol & Neurosci, Hlth Serv & Populat Res Dept, De Crespigny Pk, London WC2R 2LS, England

[5] Univ New South Wales, Sch Med Sci, Dept Exercise Physiol, Sydney, NSW 2052, Australia

[6] KU Leuven Univ Leuven, Dept Rehabil Sci, B-3000 Louvain, Belgium

[7] KU Leuven Univ Leuven, Univ Psychiat Ctr KU Leuven, B-3000 Louvain, Belgium

关键词: Schizophrenia;    Type 2 diabetes mellitus;    Medication adherence;    Meta analysis;   

DOI  :  10.1016/j.psychres.2017.01.049

来源: Elsevier

【 摘 要 】

Individuals living with schizophrenia are 2-3 times more likely to experience type 2 diabetes mellitus. Diabetes medication adherence is essential to reduce morbidity and mortality in this population. We conducted a meta analysis of diabetes medication adherence among people with schizophrenia, and compared this to those without schizophrenia. A systematic search strategy was used to identify all articles reporting adherence to diabetes medications among patients with schizophrenia. In total, 10 unique studies reporting data from 33,910 people with schizophrenia were included. Random effects meta-analysis showed people with schizophrenia adhered to medication on 77.3% of days prescribed (n=32080, 95%CI=73.6-81%, I-2=99.2%,), and adhered on 4.6% more days per year than those without schizophrenia (p < 0.01, 95%CI=2.4-6.7%, I-2=92.5%, schizophrenia n=19367, controls=170,853). Furthermore, 56% of individuals with schizophrenia (n=33680) were considered adherent (i.e. > 80% adherence over 12-24 month) to diabetes medication, which was significantly more than those without schizophrenia (OR=1.34, 95%C1: 1.18-1.52, p < 0.01). Factors which were positively associated with diabetes medication adherence were age, number of outpatient visits, along with multiple medication administration variables. Future prospective research should examine diabetes monitoring, medication prescription, and subsequent adherence in fully representative samples. Novel interventions for maximizing compliance to diabetes medication in this vulnerable population should also be explored.

【 授权许可】

Free