Type D Personality Predicts Poor Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study.

Xuemei Li,Donghua Tian,Huixuan Zhou,He Zhu,Jiaqi Yuan,Shengfa Zhang,Huiwen Xu,Fugang Wang,Zhiyong Qu,Xinfeng Tang,Xiaohua Wang,Weijun Zhang,Shuai Guo,Mohammad Ebrahim Khamseh

doi:10.1371/journal.pone.0146892

Abstract

BackgroundType D personality and medication nonadherence have been shown to be associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. However, the relationship between type D personality and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM) remains unknown. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM.Design and SettingsA follow-up study was conducted in general hospital of the People's Liberation Army in Beijing.Methods412 T2DM patients (205 females), who were recruited by circular systematic random sampling, provided demographic and baseline data about medical information and completed measures of Type D personality. Then, 330 patients went on to complete a self-report measure of medication adherence at the sixth month after baseline data collection. Chi-square test, t tests, and hierarchical multiple regression analyses were conducted, as needed.ResultsPatients with type D personality were significantly more likely to have poor medication adherence (p<0.001). Type D personality predicts poor medication adherence before and after controlling for covariates when it was analyzed as a categorical variable. However, the dimensional construct of type D personality was not associated with medication adherence when analyzed as a continuous variable.ConclusionAlthough, as a dimensional construct, type D personality may not reflect the components of the personality associated with poor medication adherence in patients with T2DM, screening for type D personality may help to identify those who are at higher risk of poor medication adherence. Interventions, aiming to improve medication adherence, should be launched for these high-risk patients.

Highlights

Type D personality describes individuals who simultaneously experience high levels of negative affectivity and social inhibition [1]
Type D personality predicts poor medication adherence before and after controlling for covariates when it was analyzed as a categorical variable
The dimensional construct of type D personality was not associated with medication adherence when analyzed as a continuous variable

Summary

Introduction

Type D personality describes individuals who simultaneously experience high levels of negative affectivity and social inhibition [1]. Previous study found that Type D personality was associated with a four-fold increased risk of mortality in coronary heart disease (CHD) patients, after controlling the traditional biomedical risk factors [4]. It’s independently associated with future hemoglobin level, while controlling for renal dysfunction, gender, time since diagnosis, and BMI in in patients with CHF [9]. Another more recent study found that Type D personality was associated with maladaptive health-related behaviors [10], this may represent one mechanism to explain the link between Type D and ill-health. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM

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