TITLE:
Adherence in Patients with Type 2 Diabetes and Depression and the Role of Physician-Patient Relationship: A Cross-Sectional Study
AUTHORS:
Nadine Mansour, Nargis Albert, Mohamed Khalil
KEYWORDS:
Depression, Type 2 Diabetes, Adherence, Physician-Patient Relationship
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.13 No.3,
July
7,
2023
ABSTRACT: Background: Diabetes mellitus (DM) challenges health and quality
of life of patients, families, and communities. Patients with comorbid depression
are more likely to develop macrovascular and microvascular complications. The aim
was to assess glycemic control and adherence in diabetic patients with comorbid
depression. Further, the study evaluated the relationship between adherence and
the physician-patient relationship. Methods: The study was conducted at Al-Agouza Family Medicine
Center (AFMC) between February 2018 and March 2020. The included patients were between
35 - 80 years of age; had type 2 diabetes with hemoglobin
A1c (HbA1c) ≥ 6.5%, fasting plasma glucose
≥ 126 mg/dl, and scored between
11 - 30 on the Beck Depression Inventory (BDI). Logistic
regression, chi-square, and analysis of variance (ANOVA) were used to assess the
relationship between depression, adherence, physician-patient relationship, and
other variables. Results: The study included 100 eligible patients with a median
BDI score of 20 (10 - 30). The median diabetic panel for patients was FBS 188 (126 - 348) mg/dl, PPS 282.50 (162 - 448) mg/dl, and HbA1c 9.5 (6.6 - 14.0)%. Depression and regular follow-up visits were statistically associated
with improvement of diabetes symptoms (p = 0.019). There was a significant relationship (p 0.001) between adherence, regular follow-up visits, and knowledge of DM. Further,
there was a significant relationship between the physician-patient relationship
and DM improvement (p = 0.047). Conclusion: Physician-patient
relationship was paramount to improving adherence and positive diabetes care. Our
findings suggest a shift to a physician-patient relationship model with mutual agreement
on medical decisions is highly recommended.