Adherence to treatment for diabetes mellitus: validation of instruments for oral antidiabetics and insulin

Abstract

Objectives to verify the face validity, criterion-related validity and the reliability of two distinct forms of presentation of the instrument Measurement of Adherence to Treatment, one being for ascertaining the adherence to the use of oral antidiabetics and the other for adherence to the use of insulin, as well as to assess differences in adherence between these two modes of drug therapy. Method a methodological study undertaken with 90 adults with Type 2 Diabetes Mellitus. The criterion-related validity was verified using the Receiver Operating Characteristic curves; and for the reliability, the researchers calculated the Cronbach alpha coefficient, the item-total correlation, and the Pearson correlation coefficient. Results the oral antidiabetics and the other showed sensitivity of 0.84, specificity of 0.35 and a Cronbach correlation coefficient of 0.84. For the adherence to the use of insulin, the values found were, respectively, 0.60, 0.21 and 0.68. A statistically significant difference was found between the final scores of the two forms of the instrument, indicating greater adherence to the use of insulin than to oral antidiabetics. Conclusion it is concluded that the two forms of the Measurement of Adherence to Treatment instrument are reliable and should be used to evaluate adherence to drug treatment among people with diabetes mellitus.

Adherence to diabetes mellitus care at three levels of health care

“…Souza JD, Baptista MHB, Gomides DS, Pace AE The Brazilian version of the "Measurement of Treatment Adherence (MTA)" 13 , which was based on the Morisky Test 14 and allows adherence to oral anti-diabetic drugs and insulin to be assessed separately, 15 was applied. The MTA contains a Likert scale composed of seven questions, each with six answer options, ranging from "one" = always to "six" = never.…”

“…8,10 One study validating the MTA oral antidiabetic agents and MTA insulin, which was developed with 90 individuals with DM2, reports a mean for adherence-to--insulin of 5.60 (SD = 0.45) and 5.60 for the use of oral antidiabetic agents (SD = 0.45). 15 The study by Arrelias et al (2015) 11 , which also used MTA in the version in which adherence to both insulin and oral antidiabetic agents is assessed, reports high scores of medication adherence: 84.2% of adherence and 15.8% of non--adherence. The study conducted by Stilli et al (2015) 18 , in turn, which used the Brief Medication Questionnaire that classifies people as adherent, probably adherent, probably poorly adherent, and poorly adherent, in a sample of 60 people, reports that 15 (25.0%) were adherent, 13 (21.7%) were probably adherent, 18 (30%) were probably poorly adherent, and 14 (23.3) were poorly adherent.…”

Insulin therapy waste produced in the households of people with diabetes monitored in Primary Care

“…In this context, insulin therapy is one of the most important treatments for people with DM and also the one which requires the most care. In addition to requiring attention in what concerns the administration procedures, insulin therapy is a waste producer, which includes needles, lancets, cotton, syringes and reagent strips (5)(6) . Since people with diabetes can make several applications of insulin a day and verify capillary blood glucose, they must be instructed on the handling and disposal of waste.…”

Conhecimento da equipe de enfermagem nas complicações do diabetes mellitus em emergência

“…According to protocol guidelines, measuring blood glucose levels systematically following a rigorous verification schedule is part of the duty of nursing professionals, as well as recording blood glucose levels and administered doses on an institutional form. (15,17) When treating diabetic ketoacidosis with intravenous insulin infusion, blood glucose must be verified on an hourly basis. After blood pH is normalized, verifications can occur every four hours.…”

“…Nursing records document the work done by the team and are indicators of quality care; whereas their incorrect completion and lack of periodicity are factors that hamper assessment, certification and the creation of indicators, and also hinders the action of inquiries and investigations that can provide professionals and institutions with legal support. (17) All nurses mentioned keeping care records on complementary observation and nursing assessment forms. They also emphasized the difference between routine care in the Internal Emergency Service and in Resting.…”