ECE2017 Eposter Presentations: Diabetes, Obesity and Metabolism Diabetes therapy (52 abstracts)
1Department of Endocrinology, Diabetes and Metabolism of Centro Hospitalar de São João, Porto, Portugal; 2Faculty of Medicine, Porto, Portugal; 3Department of Endocrinology of Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal.
Introduction: Diabetes mellitus (DM) is a chronic disease that requires continuous medical care. Health care providers should adopt approaches that improve patient outcomes and adherence.
Aims: To evaluate the adherence to Endocrinology ambulatory follow-up after elective hospital admission for decompensated DM and to determine the relationship between adherence and therapeutic success after discharge.
Methods: Retrospective study of 86 patients admitted at Endocrinology department in 20142015. Two types of assessment were available after discharge: consultation and blood analysis. Adequate adherence was defined by the compliance to ≥80% of the evaluations. We considered therapeutic success as A1c reduction ≥1.5% after discharge and persistence of success as no increase of A1c after success achievement.
Results: After discharge, 79 patients maintained ambulatory follow-up, 62 with adequate adherence. Noncompliant patients were younger (52(IQR 3960) years) than compliant patients (60(IQR 5167) years) (P=0.041). For each year of increase in patients age at admission we observed a 4% increase in adherence (OR=1.04, 95%CI 1.001.08, P=0.035). Hypertensive(HBP) patients showed 88.5% compliance (P<0.05). Patients with HBP, compared to those without HBP, showed an adherence of 9.6:1 (OR=9.60, 95%CI 2.8532.61, P<0.001). Previous treatment with metformin, DPP4i and statins was associated with a 3.9-fold (OR=3.90, 95%CI, 1.1613, 46, P=0.028), 4.7-fold (OR=4.70, 95%CI 1.2217.87, P=0.025) and 3.5-fold (OR=3.50, 95%CI, 1.1510.6, P=0.027) higher adherence, respectively. The degree of adherence to follow-up didnt influence the therapeutic success at 6 (P=0.547) nor 12 months(M) (P=0.611). Of the compliant patients, 55.4% achieved therapeutic success at 6M, however only 26.9% of these maintained success at 12M. On the other hand, of compliant patients who did not achieve therapeutic success at 6M, only 20.8% achieved it at 12M.
Conclusions: Approximately 80% of our sample showed adequate adherence. Advanced age, HBP and previous therapy with metformin, DPP4i or statin were associated with greater adherence. Therapeutic success was not related to follow-up adherence.