PDB99 - The association of adherence and health behaviors with health status among patients with type 2 diabetes in Japan

Abstract

OBJECTIVE: Although health status among patients with type 2 diabetes (T2D) in Japan can be improved with advances in treatment, there are other modifiable factors which could also be examined as potential targets for intervention. This study examined the association of adherence and health behaviors with health status in this population. METHODS: Data from the Japan 2012 National Health and Wellness Survey (NHWS) were used (N=30,000). Only respondents who reported a diagnosis of T2D and who were currently using a prescription medication were included (N=892). Smoking, exercise behavior, obesity, alcohol use, and medication adherence (measured using the Morisky Medication Adherence Scale-8 [MMAS-8]) were used as predictors of health status (measured using the Short Form-36 version 2 [SF-36v2]) controlling for demographics and comorbidities. RESULTS: 79.7% of respondents were male; the mean age was 62.2 years. Nearly two-thirds of patients had a history of smoking (23.4% were current smokers and 41.9% were former smokers) and over a quarter consumed alcohol daily. Patients exercised a mean of eight days per month and over 40% of patients were either overweight (29.4%) or obese (11.4%). Forgetfulness was the most common reason for non-adherence with medication (forgetting, 49.4%; difficulty remembering, 32.8%; forgetting when traveling/leaving home, 30.8%). Controlling for demographics and comorbidities, the strongest predictors of health status were with smoking (b= 1.62 for PCS), obesity (b= -3.16 for PCS), exercise (b= 0.15 for PCS), and not taking medications the prior day (b= -1.85 for PCS) (all p<.05). DISCUSSION: Smoking cessation, improved exercise, and weight reduction may result in significant health status improvements, aside from their well-known clinical benefits. Although forgetting medication was common among patients with T2D, the very act of taking or not taking medication the day before was predictive of physical health status. Interventions which can improve adherence rates could also have significant health status benefits. ABSTRACT