Medication adherence and quality of life among the elderly with diabetic retinopathy

Jannuzzi, Fernanda Freire; Cintra, Fernanda Aparecida; Rodrigues, Roberta Cunha Matheus; São-João, Thaís Moreira; Gallani, Maria Cecília Bueno Jayme

doi:10.1590/0104-1169.3477.2494

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Original Articles • Rev. Latino-Am. Enfermagem 22 (6) • Nov-Dec 2014 • https://doi.org/10.1590/0104-1169.3477.2494 copy

Medication adherence and quality of life among the elderly with diabetic retinopathy¹ 1 Paper extracted from master's thesis "Vision-related quality of life and medication adherence in elderly patients with diabetic retinopathy", presented to Universidade Estadual de Campinas, Campinas, SP, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

METHOD:

one hundred (n=100) elderly outpatients with diabetic retinopathy taking antihypertensives and/or oral antidiabetics/insulin were interviewed. Adherence was evaluated by the adherence proportion and its association with the care taken in administrating medications and by the Morisky Scale. The National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) was used to evaluate HRQoL.

RESULTS:

most (58%) reported the use of 80% or more of the prescribed dose and care in utilizing the medication. The item "stopping the drug when experiencing an adverse event", from the Morisky Scale, explained 12.8% and 13.5% of the variability of adherence proportion to antihypertensives and oral antidiabetics/insulin, respectively.

CONCLUSION:

there was better HRQoL in the Color Vision, Driving and Social Functioning domains of the NEI VFQ-25. Individuals with lower scores on the NEI VFQ-25 and higher scores on the Morisky Scale presented greater chance to be nonadherent to the pharmacological treatment of diabetes and hypertension.

Medication Adherence; Diabetic Retinopathy; Quality of Life; Health of the Elderly; Vision, Ocular

Proportion of medication adherence (%)
Medications	Total (n=100)		Diabetic individuals (n=15)		Diabetic and hypertensive individuals (n=85)
Antidiabetics	87.5 (19.5)		86.7 (13.3)		88.1 (20.1)
Antihypertensives	86.2 (21.1)		---		88.2 (19.6)
Antidiabetics and Antihypertensives	86.3 (18.0)		---		87.5 (18.1)
Morisky Scale
Medications	Items	Total (n=100)		Diabetic individuals (n=15)	Diabetic and hypertensive individuals (n=85)
Oral antidiabetics and/or insulin	Total	5.1 (1.6)		4.6 (1.0)	5.2 (1.7)
	Item 1	1.4 (0.7)		1.3 (0.7)	1.4 (0.7)
	Item 2	1.4 (0.9)		1.1 (0.5)	1.5 (0.9)
	Item 3	1.1 (0.3)		1.1 (0.3)	1.1 (0.3)
	Item 4	1.3 (0.7)		1	1.3 (0.8)
Antihypertensives	Total	5.4 (1.7)		---	5.4 (1.7)
	Item 1	1.5 (0.8)		---	1.5 (0.8)
	Item 2	1.5 (0.9)		---	1.5 (0.9)
	Item 3	1.1 (0.4)		---	1.1 (0.4)
	Item 4	1.3 (0.7)		---	1.3 (0.7)
Classification of global adherence to medication therapy (n=100)
Adherent					58%

Morisky Scale		Proportion of Medication Adherence*
		Antidiabetics		Antihypertensives		Both
		r	p-value	r	p-value	r	p-value
Antihypertensives (n=85)	Total	--	--	-0.45	<0.001	-0.48	<0.001
	Item 1	--	--	-0.05	0.624	-0.09	0.409
	Item 2	--	--	-0.16	0.150	-0.19	0.078
Antihypertensives (n=85)	Item 3	--	--	-0.40	<0.001	-0.40	<0.001
Antihypertensives (n=85)	Item 4	--	--	-0.59	<0.001	-0.59	<0.001
Oral Antidiabetics /Insulin (n=100)	Total	-0.38	<0.001	--	--	-0.42	<0.001
	Item 1	-0.07	0.471	--	--	-0.01	0.910
	Item 2	-0.15	0.137	--	--	-0.202	0.044
	Item 3	-0.43	<0.001	--	--	-0.39	<0.001
	Item 4	-0.40	<0.001	--	--	-0.52	<0.001

Morisky Scale (antihypertensives) (n=85)	Proportion of adherence to the antihypertensives
Morisky Scale (antihypertensives) (n=85)	Beta (SE)^†	p-value	R² Partial
Item 1*	-0.078 (0.119)	0.512	0.005
Item 2*	-0.163 (0.125)	0.197	0.022
Item 3*	-0.348 (0.220)	0.119	0.027
Item 4*	-0.462 (0.189)	0.017	0.128
Morisky Scale (antidiabetics/insulin) (n=100)	Proportion of adherence to the antidiabetics/insulin
Morisky Scale (antidiabetics/insulin) (n=100)	Beta (SE)^†	p-value	R² Partial
Item 1*	-0.136 (0.119)	0.258	0.011
Item 2*	-0.154 (0.120)	0.204	0.017
Item 3*	-0.369 (0.211)	0.083	0.030
Item 4*	-0.446 (0.158)	0.006	0.135

Variables	Categories	p-value	O.R*	CI 95%*
Visual acuity for distance vision	Profound low vision or blindness (ref.)	--	1.00	--
	Moderate low vision	0.399	1.62	0.53 – 4.94
	Normal	0.056	2.95	0.97 – 8.94
Visual acuity for near vision	Blindness (<J6)	--	1.00	--
	Low vision (J4, J5 and J6)	0.257	2.17	0.57 – 8.26
	Normal (J1, J2 and J3)	0.069	2.51	0.93 – 6.78
NEI VFQ-25 (categorized)	0-50 (ref.)	--	1.00	--
	50-74	0.283	1.92	0.58 – 6.32
	75-100	0.024	3.34	1.17 – 9.50
Morisky Scale Antihypertensives	≥8 points (ref.)	--	1.00	--
	6-7 points	0.220	2.70	0.55 – 13.20
	4-5 points	0.010	6.53	1.57 – 27.21
	Does not use	0.077	4.50	0.85 – 23.80
Morisky Scale Oral Antidiabetics and/or Insulin	Total score (for each 1 point)	--	1.00	--
Morisky Scale Oral Antidiabetics and/or Insulin	Total score (for each 1 point)	0.007	0.68	0.51 – 0.90
Morisky Scale Oral Antidiabetics and/or Insulin (categorized)	≥7 points (ref.)	--	1.00	--
	5-6 points	0.013	5.10	1.42 – 18.32
	4 points	0.002	6.35	1.98 – 10.37

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Fernanda Freire Jannuzzi Universidade Estadual de Campinas Rua Tessália Vieira de Camargo, 126 Cidade Universitária "Zeferino Vaz" CEP: 13083-887, Campinas, SP, Brasil E-mail: fernandafj@yahoo.com.br

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Medication adherence and quality of life among the elderly with diabetic retinopathy1 1 Paper extracted from master's thesis "Vision-related quality of life and medication adherence in elderly patients with diabetic retinopathy", presented to Universidade Estadual de Campinas, Campinas, SP, Brazil

METHOD:

RESULTS:

CONCLUSION:

Medication adherence and quality of life among the elderly with diabetic retinopathy¹ 1 Paper extracted from master's thesis "Vision-related quality of life and medication adherence in elderly patients with diabetic retinopathy", presented to Universidade Estadual de Campinas, Campinas, SP, Brazil