P21 Adherence to pharmacological treatment in patients with diabetes mellitus type 2 and high cardiovascular risk

Authors

  • Augusto Lavalle Cobo Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina
  • Ezequiel Forte Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina
  • Julio Napoli Institute of Diagnosis and Medical Research Formosa, Formosa, Argentina
  • Paola Harwicz Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina
  • Alfredo Romano Institute of Diagnosis and Medical Research Formosa, Formosa, Argentina
  • Emiliano Salmeri Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina
  • Carlos Klein Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina
  • Carlos Busso Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina
  • Cecilia Araya Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina
  • Mercedes Carlini Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina
  • Diana Millán Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina
  • Carolina Gómez Martín CENDIA Diabetes Center, Entre Ríos, Argentina
  • Hugo Sanabria Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v54i3Sup.405

Keywords:

pharmacological treatment, type 2 diabetes, cardiovascular risk

Abstract

Introduction: The treatment of chronic non-communicable diseases, including type 2 diabetes mellitus (DM2), generally requires changes in lifestyle and pharmacological measures. Lack of adherence is a frequent problem around de world, ranging between 30 to 50% in different studies. Non-adherent patients have a higher incidence of cardiovascular events and higher mortality compared to adherent patients. Therefore, it increases costs in the health systems.

Objective: Analyze the adherence to pharmacological treatment indicated in a group of patients with DM2 and high cardiovascular risk. Assess the differences in clinical characteristics and scopes of therapeutic goals in the adherent population in comparison with non-adherent patients.

Study design and methods: We carried out an observational, cross-sectional and multicenter study. Patients with DM2 that assisted to the cardiology office from May to July 2019, were consecutively registered. From the total p with DM2, we included in the registry, the first two p of each day. Adherence was assessed using the Morisky-Green test, which consists of 4 questions with two possible answers options: YES/NO. We defined adherence when the 4 answers were affirmative. We consider a non-adherent patient when presenting 1 or more negative answers. Therapeutic goals were defined: blood pressure under 140/90 mmHg, 2) HbA1c < 7% and 3) LDL cholesterol < 100 in patients without Cardiovascular disease (CVD) and < 70 mg/dl in patients with CVD. 4) triple goal: points 1,2 and 3 within the corresponding values.

Results: 649 p were included in this analysis: 58,5% were men with a mean time of DM2 evolution of 10,7 years. 90,9% had hypertension, 79,1% dyslipidemia, 60,1% were obese (BMI > 30km/m2), 57,6% had sedentary lifestyle and 8,8% were smokers. Overall adherence was 54,5%. The general characteristics comparing patient’s non-adherent vs those adherents are shown in Table 1. Adherents patients more frequently reached BP
levels < 140/90 (57.94 vs 42.06 p=0,01) HbA1c < 7% (61,08% vs 38,92% p=0,00001), LDL-C < 70 mg/dl (31% vs 25% p=0,03) and triple goal showing no differences in LDLC in patients without CVD (60% vs 56% p=0,1). (FIG1).

Conclusion: In our registry, half of the patients were adherent to the treatment. Adherent patients reached blood pressure goals, glycemic control and LDL targets more frequently than non-adherent patients.

Author Biographies

Augusto Lavalle Cobo, Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

Member of the Cardiometabolism Council

Ezequiel Forte, Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

Member of the Cardiometabolism Council

Paola Harwicz, Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

Member of the Cardiometabolism Council

Emiliano Salmeri, Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

Member of the Cardiometabolism Council

Carlos Klein, Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

Member of the Cardiometabolism Council

Carlos Busso, Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

Member of the Cardiometabolism Council

Cecilia Araya, Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

Member of the Cardiometabolism Council

Mercedes Carlini, Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

Member of the Cardiometabolism Council

Diana Millán, Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

Member of the Cardiometabolism Council

Carolina Gómez Martín, CENDIA Diabetes Center, Entre Ríos, Argentina

Medical specialist in Internal Medicine (University of Buenos Aires, UBA), specialized in Diabetes (Argentine Diabetes Society, SAD), Co-director of Cendia

Hugo Sanabria, Argentine Society of Cardiology, Autonomous City of Buenos Aires, Argentina

Cardiologist, specializing in diabetes; Member of the Cardiometabolism Council

Published

2023-01-10

How to Cite

Lavalle Cobo, A., Forte, E., Napoli, J., Harwicz, P., Romano, A., Salmeri, E., Klein, C., Busso, C., Araya, C., Carlini, M., Millán, D., Gómez Martín, C., & Sanabria, H. (2023). P21 Adherence to pharmacological treatment in patients with diabetes mellitus type 2 and high cardiovascular risk. Journal of the Argentine Society of Diabetes, 54(3Sup), 126–126. https://doi.org/10.47196/diab.v54i3Sup.405

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