ASSESSMENT OF THE INFLUENCE OF MEDICAL AND SOCIAL FACTORS ON THE ADHERENCE OF PATIENTS WITH DIABETES MELLITUS TO LIFESTYLE MODIFICATION
Authors: Vodolagin Mikhail V. , Ekkert Natalia V. , Kozlov Vasiliy V. 
Published: March 2022

Introduction. Diabetes mellitus is one of the most common noncommunicable diseases worldwide. At the same time, the high prevalence of various risk factors for the development of diabetes mellitus is one of the reasons for the increase in the number of patients with diabetes in all countries of the world, a high level of disability and premature mortality of people of working age. An important component of achieving the required therapeutic effect is the compliance of the patient with diabetes mellitus with the prescribed treatment and change in the usual way of life in many spheres of life. Thus, various factors related to both the quality and availability of medical care and the individual characteristics of the patient himself can affect adherence (change) to lifestyle modification.

Purpose. To explore the medico-social factors, which influencing the adherence of patients with diabetes mellitus to their lifestyle modification.

Materials and methods. The research involved 434 respondents with an established diagnosis of diabetes mellitus aged 18 to 80, including 221 women (50.92%) and 213 men (49.08%). The questionnaire consisted 2 parts, the first part, developed by the assistant M.V. Vodolagin, included 54 questions about the health status of respondents, the level of knowledge about diabetes mellitus, the presence of risk factors, the use of information and communication technologies in the treatment of diabetes mellitus and others, the second part included the “Russian universal questionnaire for quantifying adherence to treatment” (KOP-25) (developed by N. Nikolaev and Yu.P. Skirdenko, 2008). The level of adherence of patients with diabetes mellitus to lifestyle modification (change) was assessed, the main factors influencing the level of their adherence were assessed.

Results. According to the results of the survey, almost every second patient with diabetes mellitus had a low level of adherence to lifestyle modification (47.70%, n = 207, 95% CI 43.03–52.40%), statistically significant differences in the level of adherence to lifestyle modification among respondents: by type of diabetes mellitus (p <0.001), among respondents who attended Diabetes Schools (p <0.001), among respondents with a high level of knowledge about diabetes (p <0.001), among respondents who answered that they adhere to the prescribed treatment regimen (p = 0.001); among respondents who visit their attending physician more often (p = 0.009), among respondents who used remote forms of interaction with their attending physician (p <0.001), among respondents in younger age groups (p <0.001), among respondents with less long experience of diabetes mellitus (p = 0.006).

Conclusion. Due to the fact that the effectiveness of the treatment of chronic diseases depends on maintaining a high level of patient motivation, careful adherence to treatment regimens and lifestyle modifications for a long time, only the active involvement and participation of patients in the treatment process, including using modern information and communication technologies will help improve the quality of life of patients with diabetes mellitus, reduce the rate of disability and premature mortality.