ARMS 在老年 2 型糖尿病患者中用药 依从性的应用评价.

Objective To assess medication adherence in elderly patients with type 2 diabetes using the Adherence to Refills and Medications Scale（ARMS），and establish the risk forecast model of selfefficacy of inappropriate medication use based on medication adherence. Methods Patients who were hospitalized in Department of Endocrinology，Huadong Hospital, Fudan university from Jul. 2018 to Jan. 2019 were investigated by Morisky Medication Adherence Scale (MMAS-8), ARMS, and the Self- Efficacy for Appropriate Medication Use Scale（SEAMS）within 24 hours after their admission. Results Of the 505 patients enrolled，161（31.9%）were with adequate and 344（68.1%）were with inadequate selfefficacy for appropriate medication use. Two groups showed significant difference in MMAS-8，ARMS, duration of diabetes and gender（P<0.05); Spearman’s rho indicated that ARMS positively correlated and MMAS-8 negatively correlated significantly with SEAMS. Binary Logistic analysis indicated that medication adherence was the risk factor of inadequate self-efficacy for appropriate medication use（ARMS： r=0.249，OR=1.282; MMAS-8: r=-1.417, OR=0.242. ROC curve showed that the area under the curve of ARMS (AUC=0.851，P<0.001，95%CI: 0.818-0.885) was greater than MMAS-8 (AUC=0.155; P< 0.001; 95%CI: 0.121-0.189), and scores of ≥16 in ARMS can be used as a predictor for inadequate selfefficacy for appropriate medication use with a sensitivity of 80.5% and specificity of 77.6%. The risk forecast model showed good sensitivity （96.3%），specificity （73.9%） and accuracy （86.0%） in the verification group. The result of kappa statistics showed that high agreement was achieved between the verification group and risk forecast model. Conclusion Compared with MMAS-8，ARMS would be more appropriate for the evaluation of medication adherence in elderly patients with T2DM. Moreover，we can use ARMS as a tool to predict the self-management ability of medicines in the elderly patients with T2DM. [ABSTRACT FROM AUTHOR]