[Inertia and treatment compliance in patients with type 2 diabetes in primary care]

Abstract

Background and objectives: Therapeutic inertia (TI) and therapeutic compliance (TC) are 2 important barriers in achieving the therapeutic objectives recommended for patients with diabetes mellitus type 2 (DM2). This study analyzes the TI in patients with DM2 who do not achieve the glycemic, blood pressure (BP) and LDL-cholesterol (c-LDL) control goals, the patients' TC and the relationship between TI and TC.

Patients and methods: This is a descriptive study conducted in a Primary Health Care center. We included 320 diabetic patients. Objectives of control were HbA1c ≤ 7%, blood pressure (BP) ≤ 130/80 mm Hg, c-LDL ≤ 100 mg/dl, TI (when the objectives of control were not reached and the professional did not change the treatment) and TC (by counting withdrawals of pharmacy prescriptions).

Results: The objectives of control for HbA1c, BP and c-LDL were reached by 66.4, 43.2 and 40.5% of patients, respectively. There was TI in the 86.4% of patients for c-LDL, in 76.7% for BP and in 40.6% for HbA1c. The percentage of therapeutic non-compliance was of 36.1, 37.5 and 32.0% for antidiabetic, antihypertensive and lipid lowering drugs, respectively. Elderly patients were better compliants. TI and TC were not associated. We did not find differences in the level of control, TI, use of drugs and TC by sex.

Conclusions: TI and TC play an important role in the non-consecution of the control objectives in diabetic patients, especially regarding BP and lipids. TC is not related to TI.