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Medication adherence on quality of life among adults with type 2 diabetes mellitus: an exploratory analysis on the EDDMQoL study

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Abstract

Purpose

This study examined the association between medication adherence (MA) and health-related quality of life (HRQoL) among the adult type 2 diabetes mellitus at the primary care level.

Methods

In this cross-sectional study, the 8-item Morisky Medication Adherence Scale (MMAS) was the main independent variable and the World Health Organization Quality of Life-Brief the dependent variable. Besides socio-demographic data, diabetes-related distress (DRD) and depression (DS) were included as covariates. Independent association between the MMAS score and HRQoL was done using multiple linear regression.

Results

The participants’ response rate was 93.1 % (700/752). Majorities were female (52.8 %), Malay (52.9 %) and married (79.1 %). The mean (SD) for age and the MMAS score was 56.9 (10.18) and 5.6 (1.42), respectively. MMAS total score correlated significantly with all HRQoL domains: overall QoL (OQoL) (r = 0.17), physical QoL (r = 0.11), psychological QoL (r = 0.10), social relationship QoL (r = 0.15) and environmental QoL (EQoL) (r = 0.18). After adjustment for covariates (age, gender, ethnicity, religion, education, income, exercise, macrovascular complications, DRD and DS), MA had persistent effects on OQoL (B = 0.53, 95 % CI 0.012–1.048) and EQoL (B = 0.95, 95 % CI 0.235–1.667).

Conclusion

MA showed prevalent correlation and positive effects on the domains of HRQoL. Despite the small effects of MA on HRQoL, the sheer presence of the independent effects provides healthcare providers good reason for initiative and intervention to improve MA, which would improve quality of life.

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Abbreviations

DDS:

The 17-item Diabetes Distress Scale

DFP:

Diabetic foot problems

DRD:

Diabetes-related distress

DS:

Depression

EQoL:

Environment quality of life

HRQoL:

Health-related quality of life

MA:

Medication adherence

MacroCx:

Macrovascular complications

MicroCx:

Microvascular complications

MMAS:

The 8-item Morisky Medication Adherence Scale

OQoL:

Overall quality of life

PHQ:

The 9-item Patient Health Questionnaire

PQoL:

Physical quality of life

SRQoL:

Social relationships quality of life

T2DM:

Type 2 diabetes mellitus

WHOQOL-BREF:

The World Health Organization Quality of Life-Brief

YQoL:

Psychological quality of life

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Acknowledgments

This study received its funding from the Research University Grants Scheme 2 (RUGS/04-02-2105RU). I would like to record my acknowledgment to WHO and Dr. Al-Qazaz H.K. et al. for the use of WHOQOL-BREF and the MMAS-8 Malay version, respectively. I also like to acknowledge the Sepang and Petaling District Health Offices and officers for their support in this study and Director General of Health for his permission to publish this report. I thank Dr. Firdaus Mukhtar, Professor Sherina Mohd Sidik, Dr. Nor-Kasmawati Jamaludin and Dr. Fuziah Paimin for their input during the study planning and assistance in data collection. Lastly, I would like to thank all the clinic staffs for facilitating the data collection.

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Authors and Affiliations

  1. Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia

    Boon-How Chew

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  1. Boon-How Chew
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Correspondence to Boon-How Chew.

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Chew, BH. Medication adherence on quality of life among adults with type 2 diabetes mellitus: an exploratory analysis on the EDDMQoL study. Qual Life Res 24, 2723–2731 (2015). https://doi.org/10.1007/s11136-015-1006-7

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