PMID- 24904183
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220317
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 48
IP  - 8
DP  - 2014 Aug
TI  - Regimen-Related Distress, Medication Adherence, and Glycemic Control in Rural 
      African American Women With Type 2 Diabetes Mellitus.
PG  - 970-977
AB  - BACKGROUND: Regimen-related emotional distress in patients with type 2 diabetes 
      mellitus (T2DM) is associated with poor glycemic control, but the mediators of 
      this relationship are not well described. OBJECTIVE: This cross-sectional study 
      at baseline examines these relationships, including the specific role of 
      medication adherence in rural African American women. METHODS: At baseline in the 
      EMPOWER randomized trial, the investigators collected the following data: 
      Regimen-Related Distress (RRD; subscale of the validated Diabetes Distress 
      Scale), diabetes medications, medication adherence using the Morisky Medication 
      Adherence Scale, and hemoglobin A(1C) (A1C). RESULTS: The study enrolled 189 
      rural African American women with T2DM (mean age = 53 +/- 11 years, A1C = 9.1% +/- 
      1.8%, body mass index = 37.7% +/- 8.2%; 61% on insulin); 56% reported elevated RRD 
      (mean >/= 3.0), and this was associated with significantly lower medication 
      adherence (4.4 vs 6.4, P < 0.001) and significantly higher A1C (9.5% vs 8.6%, P < 
      0.001). In multivariate modeling, both elevated RRD (exp beta = 2.1; 95% CI = 
      1.1-4.2; P < 0.05) and lower medication adherence (exp beta = 3.3; 95% CI = 1.1-9.6; 
      P < 0.05) were independently associated with higher A1C values. In mediation 
      analysis, medication adherence was a significant mediator of the effects of RRD 
      on A1C. CONCLUSION: Among rural African American women with T2DM, elevated levels 
      of RRD were common and were associated with higher A1C values, in part via 
      effects on medication adherence. Complex treatment regimens accompanied by 
      psychological distress may be associated with poorer glycemic control.
CI  - (c) The Author(s) 2014.
FAU - Cummings, Doyle M
AU  - Cummings DM
AD  - East Carolina University, Greenville, NC, USA cummingsd@ecu.edu.
FAU - Lutes, Lesley
AU  - Lutes L
AD  - East Carolina University, Greenville, NC, USA.
FAU - Littlewood, Kerry
AU  - Littlewood K
AD  - East Carolina University, Greenville, NC, USA.
FAU - DiNatale, Emily
AU  - DiNatale E
AD  - East Carolina University, Greenville, NC, USA.
FAU - Hambidge, Bertha
AU  - Hambidge B
AD  - East Carolina University, Greenville, NC, USA.
FAU - Schulman, Kathleen
AU  - Schulman K
AD  - East Carolina University, Greenville, NC, USA.
FAU - Morisky, Donald E
AU  - Morisky DE
AD  - UCLA Fielding School of Public Health, Los Angeles, CA, USA.
LA  - eng
GR  - P30 DK093002/DK/NIDDK NIH HHS/United States
PT  - Journal Article
DEP - 20140605
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
OTO - NOTNLM
OT  - Regimen-Related Distress
OT  - glycemic control
OT  - medication adherence
EDAT- 2014/06/07 06:00
MHDA- 2014/06/07 06:01
CRDT- 2014/06/07 06:00
PHST- 2014/06/07 06:00 [entrez]
PHST- 2014/06/07 06:00 [pubmed]
PHST- 2014/06/07 06:01 [medline]
AID - 1060028014536532 [pii]
AID - 10.1177/1060028014536532 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2014 Aug;48(8):970-977. doi: 10.1177/1060028014536532. Epub 
      2014 Jun 5.