Memory complaints linked to lower self-reported type 2 diabetes medication adherence
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Adults with type 2 diabetes and more memory complaints are more likely to underreport medication adherence compared with those with fewer memory complaints, according to study data.
In findings from a cohort of adults with type 2 diabetes who completed a prospective and retrospective memory questionnaire, adults with fewer memory complaints self-reported medication use at a similar rate to electronically monitored medication adherence, whereas there was less correlation between self-reported and electronically monitored medication adherence for adults with higher scores on the memory questionnaire.
“The study sheds light on personal and questionnaire factors that might interfere with reporting adherence and attempts to look at memory complaints as a variable that impacts the concordance among self-reports and subjective measures of adherence,” Jeffrey S. Gonzalez, PhD, professor of psychology at the Ferkauf Graduate School of Psychology at Yeshiva University in New York, and professor in the departments of medicine (endocrinology) and epidemiology and population health at Albert Einstein College of Medicine in New York, and colleagues wrote in a study published in The Journal of Diabetes and Its Complications. “This topic is particularly important given that studies and clinicians are more likely to use self-reported measures, and self-reported measures tend to be more closely associated with glycemic control.”
Researchers recruited from specialty and primary care clinics in the Bronx, New York, 104 adults who were prescribed oral medications for type 2 diabetes (mean age, 56 years). Participants received an electronic medication bottle cap to record prescription bottle openings for 3 months. Oral antihyperglycemic medications were electronically monitored. If the participants did not use an antihyperglycemic medication, a medication prescribed for cholesterol or blood pressure was tracked instead. The most frequent or difficult to remember medication was tracked for those taking multiple medications. Participants were asked to report their medication adherence at the end of the 3 months on a scale ranging between 0% and 100%. Adults completed a 16-item prospective and retrospective memory questionnaire, with a higher score indicating more memory complaints. The Montgomery-Åsberg Depression Rating Scale was used to measure depression.
The study cohort had a mean electronically measured medication adherence of 72.5%, lower than the self-reported adherence rate of 82.9% (P = .007). Self-reported and electronically monitored adherence were significantly correlated (r = 0.33; P < .001). Depressive symptoms were associated only with self-reported medication adherence (r = –0.24; P = .02). A higher memory complaints score was associated with more depressive symptoms (r = 0.47; P < .001) and lower self-reported medication adherence (r = –0.31; P = .001).
In moderation analysis, self-reported medication adherence was closely associated with electronically monitored adherence for adults with low levels of memory complaints (beta = 0.76; P < .001). The associations were weaker for those with high levels of memory complaints (beta = 0.28; P = .02). Adults who underreported their medication adherence compared with the electronically monitored adherence rate had a higher score on the memory questionnaire than those whose self-reported adherence was similar to the electronically monitored rate (44.26 vs. 36.68; P = .016).
“More studies of this type are needed in order to increase the validity of self-reported adherence that are often used across clinical and research settings,” the researchers concluded. “The present findings suggest that screening for retrospective and prospective memory complaints may inform and facilitate the concordant assessment of self-reported medication adherence.”
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