The aim of the study was toassess the level of depression in type 2 diabetes mellitus patients using Patient Health Questionnaire (PHQ-9), to evaluate the range of medication adherence and to identify the reasons for nonadherence to medication in type 2 diabetes mellitus patients with depression. Study tools such as Morisky Medication Adherence Scale (MMAS), Patient Health Questionnaire 9 (PHQ- 9) and Daily Diabetes Record Sheet were used. Chisquare test was used to test the association for categorical variables and the Student's t-test was used for group comparisons. Patients with high adherence to medication were found to have good glycemic control than low medication adherence patients. The level of depression of more than half of the patients (51.9%) lies in between PHQ score of 10 and 14 in this study. Reasons for non-adherence were accidental and intentional. The most prevalent among accidental reasons was patient forgetting to take medicines (25.0%), and the most prevalent among intentional reasons was achievement of treatment goals (17.59%). The result outcome of the study states that the level of depression has a significant effect on poor metabolic control, poor diet and non-adherence to the medication regimen.
___
[1] Golden SH, Lazo M, Carnethon M, Bertoni AG, Schreiner PJ, Roux AV, Lee HB, Lyketsos C. Examining a bidirectional association between depressive symptoms and diabetes. Jama. 2008; 299(23): 2751–2759. [CrossRef]
[2] Genuth S. A case for blood glucose control. Adv Intern Med. 1995; 40: 573–623. [CrossRef]
[3] Reichard P, Nilsson BY, Rosenqvist V. The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus. N Engl J Med. 1993; 329(5): 304–309. [CrossRef]
[4] Gavard JA, Lustman PJ, Clouse RE. Prevalence of depression in adults with diabetes: an epidemiological evaluation. Diabetes Care. 1993; 16(8): 1167–1178. [CrossRef]
[5] Wing RR, Marcus MD, Blair EH, Epstein LH, Burton LR. Depressive symptomatology in obese adults with type II diabetes. Diabetes Care. 1990; 13(2): 170 – 172. [CrossRef]
[6] Jacobson AM, De Groot M, Samson JA. The effects of psychiatric disorders and symptoms on quality of life in patients with type I and type II diabetes mellitus. Qual Life. 1997; 6(1): 11–20. [CrossRef]
[7] Hanninen JA, Takala JK, Keinanen-Kiukaanniemi SM. Depression in subjects with type 2 diabetes: predictive factors and relation to quality of life. Diabetes Care. 1999; 22(6): 997–998. [CrossRef]
[8] Gary TL, Crum RM, Cooper Patrick L, Ford D, Brancati FL. Depressive symptoms and metabolic control in AfricanAmericans with type 2 diabetes. Diabetes Care. 2000; 23(1): 23–29. [CrossRef]
[9] Ciechanowski PS, Katon WJ, Russo JE. Depression and diabetes: impact of depressive on adherence, function, and costs. Arch Intern Med. 2000;160(21):3278-3285. [CrossRef]
[10] Lin EH, Katon W, Von Korff M, Rutter C, Simon GE, Oliver M, Ciechanowski P, Ludman EJ, Bush T, Young B. Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care. 2004; 27(9): 2154–2160.
[11] Culbertson FM. Depression and gender- An international review. Am Psychol. 1997; 52(1): 25-31. [CrossRef]
[12] A li S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2006; 23(11): 1165-1173. [CrossRef]
[13] Eren I Erdi O, Ozcankaya R. Relationship between blood glucose control and psychiatric disorders in type II diabetic patients. Türk Psikiyatri Derg. 2003; 14(3): 184-191.
[14] Hillary R Bogner, Knashawn H Morales, Heather F de Vries, Anne R Cappola. Integrated management of Type 2 diabetes mellitus and depression treatment to improve medication adherence: A randomized controlled trial. Ann Fam Med. 2012; 10(1):15-22. [CrossRef]