Treatment method and adherence in patients with hypertension and type 2 diabetes mellitus

Introduction Type 2 diabetes (DM) and hypertension (HA), are recognized as a leading health, social and economic problem. The prevalence of HA among Polish adults is 31%, of which 70% are patients with DM. The treatment regimen for type 2 DM is often complex and includes elements of behavioral therapy, pharmacotherapy and insulin therapy. However, in order for the patient to adhere to the therapeutic regimen, treatment must be tailored to the patient's capabilities. The more difficult the therapeutic regimen, the lower the adjustment to adherence. The purpose of this study was to evaluate the relationship between the method of treatment and the level of adherence to therapeutic recommendations by patients suffering from HA and type 2 DM simultaneously. Material and methods The Adherence to Refills and Medications Scale (ARMS) and the Diabetes Treatment Satisfaction Scale (DTSQ) were used in the study. The study included 150 patients divided into 3 groups according to the method of treatment (group I (n=86)-treated with pills, group II (n=20)-treated with insulin, group III (n=44)-treated with botills and insulin. Results A comparative analysis of the level of adherence to pharmacological recommendations as perceived by patients showed significant differences between the groups, and the highest level was achieved by the group treated with insulin only 16.7±7.4, and the lowest level in the group treated with a combined regimen (tablet+insulin) 19.6±8.1; p=0.020). In the assessment of satisfaction with treatment, statistically significant differences in satisfaction were observed in the group of patients treated with the combination regimen, where more than half (55%) of the respondents showed complete lack of satisfaction with treatment. In univariate correlation analysis, the type of treatment regimen was not related to the level of adherence to pharmacological recommendations and adherence to health behaviors. However, a significant effect of comorbidities, acute complications of diabetes, early neurological incidents in the course of diabetes, and age and education of the respondents was observed. In multivariate analysis, a statistically significant independent determinant of adherence to pharmacological recommendations was the absence of comorbidities and the level of adherence to health recommendations was influenced by the age of the respondents. Conclusions The method of diabetes treatment has no effect on the level of health behavior in patients with NT and type 2 DM. The highest level of adherence to pharmacological recommendations of diabetes treatment is found in patients treated with insulin only and the lowest in patients treated with pills and insulin. Patients treated with the combination regimen have low levels of treatment satisfaction.