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Prospective memory lapses cause missed medication in adults with diabetes
Nearly one-quarter of adults with diabetes forget to take medication at least once every 2 weeks, and prospective memory slips are one of the primary causes, according to findings published in Diabetic Medicine.
“Several studies have shown the importance of cognition for effective diabetes self-management,” Steven Trawley, PhD, BSc, a cognitive research psychologist at the Cairnmillar Institute in Australia, and colleagues wrote. “However, the type of cognitive function that specifically relates to remembering to take medication, commonly referred to as prospective memory, is rarely mentioned in the diabetes research literature.”
Trawley and colleagues examined data from adults with type 1 (n = 901; mean age, 44 years; 60% women) or type 2 diabetes (n = 927; mean age, 63 years; 42% women) collected from the Diabetes MILES-2 study, a national online, cross-sectional survey in Australia. From March 23 to May 11, 2015, participants completed online questionnaires that assessed how often they forgot to take medication during the previous 2 weeks as well as prospective and retrospective memory function, as measured by the Prospective and Retrospective Memory Questionnaire (PRMQ), and frustration levels for each. The PRMQ survey was split into two 40-point subscales, with a higher score indicating more issues with each respective memory function.
Among the participants with type 1 diabetes, the researchers found that 23% forgot to take their medication at least once in a 2-week span, whereas 12% intentionally skipped medication at least once. Based on the PRMQ readings in this population, prospective memory issues were reported more frequently (19.2) than retrospective memory problems (16.1; P < .001). Prospective memory lapses were considered frustrating by more participants (42%) than retrospective memory breaks (35%; P = .002). Forgetting to take medication was associated with younger age (P < .001), insulin pump use (P = .016), fewer blood glucose checks (P = .016), higher HbA1c levels (P = .001) and more prospective memory slips (P < .001).
In participants with type 2 diabetes, 23% forgot to medication at least once, whereas 7% of respondents reported intentionally skipping medication. Although there was no significant difference in reported frustration levels between prospective and retrospective memory slips in this cohort, younger age (P < .001), insulin treatment (P < .001) and more prospective memory slips (P < .001) were linked to lower rates of medication adherence.
“Only prospective memory slips were associated with medication forgetting in the final regression models for both type 1 and type 2 diabetes,” the researchers wrote. “This highlights the clinical relevance of prospective memory functioning among adults with diabetes, which has previously gone unrecognized as research has focused primarily on retrospective memory functioning.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.