Factors Associated with Compliance Using Diamicron in Patients with Type 2 Diabetes

BACKGROUND: Diabetes mellitus (DM) is one of the most important chronic diseases in public health, thus optimal management of this condition is crucial. For this purpose, oral hypoglycemic agents (OHA) are commonly prescribed with their consistent use being mandatory to maintain adequate blood glucose levels. We aimed to evaluate the compliance with OHA in patients with DM, and to determine the factors associated with compliance. METHODS: From March 2006 to December 2007, we enrolled patients with type 2 DM who were newly diagnosed or had discontinued OHAs for more than four weeks. For OHA, diamicron was prescribed to the participants and response to medication was evaluated by physicians after 12 weeks. Compliance was defined as patients taking diamicron continuously or stopping the medication due to well-controlled blood sugar levels. Demographic characteristics, anthropometric measurements, fasting glucose, and lipid profiles were collected and analyzed. RESULTS: The mean age of our 326 subjects was 56.0+/-9.9 years and 74.5% was defined to be compliant. Logistic regression analysis adjusting for age and sex revealed that combined medication use (odd ratio [OR], 2.03; 95% confidence interval [CI], 1.04-3.97) and diabetes-related nutritional education (OR, 2.08; 95% CI, 1.08-4.03) (P<0.05) were factors associated with compliance with OHA. CONCLUSIONS: About three quarters of the DM patients in our study, using diamicron for the first time, showed compliance after 12 weeks of treatment. Concomitant medications and diabetes-related nutrition education were associated with compliance.

Analysis of belief and practice levels of family physicians concerning primary care

BACKGROUND: This study was conducted to evaluate belief and practice levels of family physicians concerning primary care is settled or not. METHODS: The target population were those family physicians having finished their three-year residency course in family medicine after 1989. Out of 2,075 people, the addresses 945were identified of This was a sample population. We exckyded 63persins who worked in medical school. The questionnaires were sent twice during July to September in 1998, and contents were constructed if general characteristics, items of belief and practice level of five areas of primary care(1977, IOM - Accessibility, Comprehensiveness, Continuity, Coordination, Accountability). RESULTS: Response rate was 32.1%(total : 270 : 1st respondents : 226 and 2nd : 44). Average belief level concerning principles of primary care was 4.45 point(5 point scale), and according to area rate continuity, coordination, comprehensiveness, accountability which was significant(p=0.00). Average practice level(5 point scale) concerning principles of primary care was 3/64 point. In order of strength of belief : accessibility, comprehensiveness, coordination, accountability, continuity, which was significant (p=0.00). The highest concordance between belief and practice was accessibility(p=0.00) and the highest gap was continuity(p=0.00). Compared with the unsatisfied group, the satisfied group had higher practice level(p=0.00). Significant variables that affect practice level were belief level, opening, satisfaction(r2=0.27, p=0.00). The opinion of whether primary care was settled was mostly negative(95.8%). CONCLUSION: Although, family physicians were revealed to have relatively high belief and practice level concerning primary care, their opinions about primary care setting werew negative. There is a lot of significant gap between individual level as family physician and societal level in primary care. More studies need to be conducted to determine the causes of such difference.