Medication Adherence Mediates the Association between Type D Personality and High HbA1c Level in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study.

Xuemei Li,Weijun Zhang,Donghua Tian,Huiwen Xu,Huixuan Zhou,Shengfa Zhang,Jing Guo,Xiaohua Wang,Min Gao,Zhiyong Qu

doi:10.1155/2017/7589184

Abstract

Aims. To examine the association between Type D personality and HbA1c level and to explore the mediating role of medication adherence between them in patients with type 2 diabetes mellitus (T2DM). Methods. 330 patients went on to complete a self-report measure of medication adherence and the HbA1c tests. Chi-square test, T test, Ordinary Least Square Regression (OLS), and Recentered Influence Function Regression (RIF) were employed. Results. Patients with Type D personality had significantly higher HbA1c value (P < 0.01). When Type D personality was operationalized as a categorical variable, SI was associated with HbA1c (P < 0.01). When NA, SI, and their interaction term were entered into regression, all of them were no longer associated with HbA1c level (P > 0.1). On the other hand, when Type D personality was operationalized as a continuous variable, only SI trait was associated with HbA1c level (P < 0.01). When NA, SI, and NA × SI term together were entered into regression, only SI was not related to HbA1c level. Furthermore, medication adherence had a significant mediation effect between Type D personality and HbA1c, accounting for 54.43% of the total effect. Conclusion. Type D personality was associated with HbA1c in direct and indirect ways, and medication adherence acted as a mediator role.

Highlights

Adherence has been defined by World Health Organization (WHO) as “the extent to which a person’s behavior-taking medications, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider” [1]
This study aimed to explore whether there is a direct association between Type D personality and higher Glycated haemoglobin Ordinary Least Square Regression (OLS) (HbA1c) level, or whether medication adherence acted as a mediating role, or whether both the direct and the indirect association coexist between Type D personality and HbA1c in Chinese population with type 2 diabetes mellitus (T2DM), after controlling for demographic, clinical, and behavioral characteristics
The findings showed that Type D personality was significantly associated with higher HbA1c level at T2 in patients with T2DM, which were similar to the high prevalence rates of Type D personality in other patient groups such as those suffering from hypertension, myocardial infarction, and heart failure [4, 29]

Summary

Introduction

Adherence has been defined by WHO as “the extent to which a person’s behavior-taking medications, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider” [1]. Adequate adherence enhances treatment safety and treatment effectiveness and further leads to reduced mortality, morbidity, and considerable direct and indirect costs to healthcare system [2, 3]. Accumulating evidence presented that Type D personality is significantly associated with medication adherence in patients with chronic disease [4, 5] and has a deleterious influence on the patient’s self-behavior [6]. Previous studies revealed that poor self-management such as medication adherence can lead to life-threating complications including microvascular or macrovascular disease for the patients with T2DM [9], or with chronic heart failure [10], and/or with peripheral arterial disease [11]

Methods

Discussion

Conclusion