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- Tzahit Simon-Tuval, Amir Shmueli, and Ilana Harman-Boehm.
- a Department of Health Systems Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences , Ben-Gurion University of the Negev , Israel.
- Curr Med Res Opin. 2018 Feb 1; 34 (2): 345351345-351.
ObjectiveTo examine whether risk tolerance is associated with adherence to oral hypoglycemic agents (OHAs).MethodsWe performed a cross-sectional study among adult patients with type 2 diabetes mellitus (n = 308) presenting for routine out-patient visits, using validated questionnaires to estimate: risk preferences (risk-seeking, risk averse, risk neutral), motivation, self-efficacy, impulsivity, perception of the disease and of the interpersonal process of care, demographic and socioeconomic characteristics; computerized patient medical records to estimate disease severity and a computerized database for retrieval of medication adherence, 1 year before the interview. Adherence was estimated using prescription-based measures of proportion of days covered (PDC). Concurrent adherence was calculated as: PDC with ≥1 OHAs; average PDC; PDC of ≥80% for all OHAs.ResultsMultivariable ordered logit model revealed that compared to others, risk-seeking patients had lower PDC with ≥1 OHAs (β = -0.50, p ≤ .1). Specifically, risk-seeking patients were 11.2 percentage points less likely to have ≥80% of the follow-up period covered with ≥1 OHAs available (p ≤ .1). In addition, risk-seeking patients had lower average PDC (β = -0.85, p ≤ .05). Specifically, these patients were 19.5 percentage points less likely to have an average PDC of ≥80% (p ≤ .05). Multivariable logistic model revealed that risk-seeking was associated with lower probability of having PDC ≥80% for all OHAs in the follow-up period (OR; 90% CI: 0.59; 0.35-0.97).ConclusionsRisk-seeking patients are less adherent to OHA medications. Identifying these patients may enable practitioners to proactively tailor strategies to improve their adherence and health outcomes.
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