Psychological, emotional and social impairments are associated with adherence and healthcare spending in type 2 diabetic patients: an observational study

Eur Rev Med Pharmacol Sci. 2019 Jan;23(2):749-754. doi: 10.26355/eurrev_201901_16889.

Abstract

Objective: The aim of the present study was to assess the association among anxiety, depression, stress, social support and emotional abilities with adherence and healthcare spending in type 2 diabetic patients.

Patients and methods: Sixty-four patients were enrolled and completed: Interpersonal Processes of Care (IPC), 20-item Toronto Alexithymia Scale (TAS-20), Rapid Stress Assessment Scale (RSAS), Morisky Medication Adherence Scale (MMAS-4), International Physical Activity Questionnaire (IPAQ)-Short Form and a socio-anamnestic questionnaire regarding also the healthcare spending.

Results: Mathematical linear regressions models were performed showing the predictive effects of: anxiety and social support scores (RSAS) on adherence levels (respectively p =. 019; p =. 016); adherence levels on anxiolytic use (p =.04); aggressiveness scores (RSAS) on the number of general check-ups (p =.031); TAS-20 and physician-patient communication (IPC) on the number of hospitalization days (respectively p=.001; p=.008); physician patient decision making (IPC) scores on physical activity (IPAQ) levels (p=.025); physical activity (IPAQ) on the number of medical examinations (p=.039).

Conclusions: An association among psychosocial impairment, adherence and healthcare spending was found. Future studies should investigate the effect of a brief psychological intervention in increasing adherence levels and reducing the healthcare spending in this clinical population.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety / diagnosis
  • Anxiety / economics
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Depression / diagnosis
  • Depression / economics
  • Depression / epidemiology
  • Depression / psychology
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / psychology*
  • Female
  • Health Expenditures / statistics & numerical data*
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Psychometrics / statistics & numerical data
  • Self Report / statistics & numerical data
  • Social Support*
  • Stress, Psychological / diagnosis
  • Stress, Psychological / economics
  • Stress, Psychological / epidemiology
  • Stress, Psychological / psychology