(CTN News) – A major barrier to treating diabetes is the failure to take medications as prescribed, a phenomenon that is more prevalent among African American patients than among white patients.
Two related factors have been studied among middle-aged and older African Americans — depression symptoms and concerns about medication.
Their findings have been published in the Community Mental Health Journal, adding to the growing body of evidence suggesting that physicians must take a more comprehensive approach to patient care than simply writing prescriptions.
As a part of a larger clinical trial in which the use of educational efforts to reduce emergency department visits by African American patients with diabetes was tested, Eric Sah, a medical student at Thomas Jefferson University and study author, utilized data collected as part of the trial.
According to the study, he analyzed the responses of patients to questions regarding their beliefs regarding their condition and their medication, as well as their depressive symptoms.
Also included in the study were measurements of their hemoglobin A1c, a measure of blood glucose control over a prolonged period of time. His study expanded upon an earlier analysis of similar data, published in the American Journal of Geriatric Psychiatry.
During Shah’s analysis, it became apparent that the more signs of depression someone reported, the less likely they were to approve of their diabetes medications’ side effects. In addition, they had to overcome the barriers they had to overcome to take their medications correctly.
Moreover, patients who had poor blood glucose control perceived greater barriers to taking their medications appropriately the worse their blood glucose control was. Depression symptoms were also associated with decreased diabetes control, although the relationship was less severe. In this respect, the results are consistent with those discovered in the earlier analysis, which uncovered the same pattern.
Researchers from both diabetes studies suggest that doctors should ask patients about their beliefs about medications and address those beliefs directly.
This is according to Barry Rovner, MD, a senior researcher on all three studies. It is important for physicians to ask their patients “What do you think about these medications?”,” Dr. Rovner advises. As a physician, if he or she directs a patient to take a medication, it would be more effective than stating, “Do you have diabetes? You should take this medication.”
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