A comparison of adherence to hypoglycemic medications between Type 2 diabetes patients with and without serious mental illness

Abstract

Inadequate self-management of chronic medical conditions like Type 2 diabetes may play a role in the poor health status of individuals with serious mental illnesses. We compared adherence to hypoglycemic medications and blood glucose control between 44 diabetes patients with a serious mental illness and 30 patients without a psychiatric illness. The two groups did not differ in their ability to manage a complex medication regimen as assessed by a performance-based measure of medication management capacity. However, significantly fewer patients with a mental illness self-reported nonadherence to their hypoglycemic regimens compared to those without a mental illness. Although individuals with mental illnesses also had better control of blood glucose, this metabolic parameter was not correlated with adherence to hypoglycemic medications in either patient group. The experience of managing a chronic mental illness may confer advantages to individuals with serious mental illnesses in the self-care of co-occurring medical conditions like Type 2 diabetes.

Glucose Control and Medication Adherence Among Veterans With Diabetes and Serious Mental Illness: Does Collocation of Primary Care and Mental Health Care Matter?

“…Another possible explanation is patients' established experience with managing a chronic medical condition (i.e., SMI). Both of these potential explanations are consistent with literature indicating that adherence to diabetes medications in veterans with SMI is better than those without SMI and improves with visit frequency (28,29).…”

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

“…Additionally, searching the reference lists of retrieved studies identified 2 further studies which were eligible for inclusion in this review (Dixon et al, 2004;Nelson et al, 2011). Therefore, these 4 articles were added to the 6 studies from our original search (Dolder et al, 2003;Farley et al, 2012;Hansen et al, 2012;Kreyenbuhl et al, 2011;Kreyenbuhl et al, 2010;). In total, 10 articles were included in this review, reporting data from 33,910 psychiatric patients, 94.6% of which had a confirmed diagnosis of schizophrenia / schizoaffective disorder.…”

“…with at least 80% of days covered by medications) over a 12-month or 24-month timeframe (Desai et al, 2014;Farley et al, 2012;Hansen et al, 2012;Kreyenbuhl et al, 2010;Kreyenbuhl et al, 2011;Nelson et al, 2011;Piette et al, 2007;Simard et al, 2015). In total, 57.6% of patients with schizophrenia were adherent to diabetes medications (N=6, n=33,680; 95% CI=48.5%-66.5%, Q=1243, p<0.01, I 2 =99.6%).…”

“…One further study using self-report measures (and thus not included in the meta-analysis) (Kreyenbuhl et al, 2011) also found that people with schizophrenia were more likely to be adherent over the previous week than people without mental illness.…”

Ethnic differences in primary care management of diabetes and cardiovascular disease in people with serious mental illness

“…10 Similar findings have been reported from integrated care in both Canada and the US. 11,12 Continuity of primary care is associated with treatment retention and survival benefit. 13 Psychoses are more common among black African or Caribbean groups, 14,15 and the accumulation of cardiovascular risk factors in these groups is associated with additional comorbidities and mortality.…”