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Is self-reported adherence a valid measure of glycaemic control among people living with diabetes in rural India? A cross-sectional analysis

  • Author Footnotes
    1 Currently; Scientist-E (Medical), ICMR- National Institute for Research in Tuberculosis (NIRT), Chethpet, Chennai, India – 600031.
    Leeberk Raja Inbaraj
    Correspondence
    Correspondence to: Division of Community Health, Bangalore Baptist Hospital, Bengaluru 56004, India.
    Footnotes
    1 Currently; Scientist-E (Medical), ICMR- National Institute for Research in Tuberculosis (NIRT), Chethpet, Chennai, India – 600031.
    Affiliations
    Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Bengaluru, India

    Department of Clinical Research, ICMR- National Institute for Research in Tuberculosis, Chennai, India
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  • Elsa Heylen
    Affiliations
    Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, USA
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  • Krishnamachari Srinivasan
    Affiliations
    Department of Psychiatry, St John's Medical College Hospital, Bengaluru, Karnataka, India

    Division of Mental Health and Neurosciences, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
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  • Maria L. Ekstrand
    Affiliations
    Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, USA

    Division of Mental Health and Neurosciences, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
    Search for articles by this author
  • Author Footnotes
    1 Currently; Scientist-E (Medical), ICMR- National Institute for Research in Tuberculosis (NIRT), Chethpet, Chennai, India – 600031.
Published:November 03, 2022DOI:https://doi.org/10.1016/j.pcd.2022.10.009

      Highlights

      • Visual analogue scale (VAS) is a simple tool to measure medication adherence.
      • VAS has not been widely used or validated in Indian setting.
      • Self-reported adherence scales may not be reliable in a rural population.
      • Need for innovative, easy-to-administer measures that can be used in rural settings.

      Abstract

      Background

      Visual analogue scale (VAS) is one of the simplest to measure medication adherence. It has neither been widely used for Non communicable diseases (NCD) nor validated for in the Indian setting. We examined the validity of self-reported medication adherence measures in relation to HbA1C in a rural population with diabetes mellitus (DM).

      Methods

      Participants with DM was administered VAS, Diabetes Self-Management Questionnaire (DMSQ) and assessed for missed pills. Descriptive statistics and logistic regression analysis were done.

      Results

      We recruited 1347 participants and 84% of them reported being 100% adherent as per VAS and 83.8% stated that they did not miss any pills. However, 58.2% of participants who reported having 100% adherence had poor glycaemic control, as did 58.1% of those who did not miss any pills. None of the diabetic self-care measures was significantly associated with glycaemic control.

      Conclusion

      We found a lack of association between self-reported adherence measures and glycaemic control in participants with DM suggesting that self-reported adherence scales may not be valid in this population.

      Keywords

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