Psychological social and emotional impairments are associated with adherence and healthcare spending in type 2 diabetic patients: an observational study

More than three million of Italians suffer from diabetes. The economic impact could be explained by poor adherence to the treatment. Previous studies showed that emotional, psychological and social impairments may have an influence on adherence to the treatment in diabetics. The aim of the present study was to assess the association among anxiety, depression, stress, social and emotional abilities with adherence and healthcare spending. Sixty-four type 2 diabetic patients were enrolled. Interpersonal Processes of Care (IPC), Toronto Alexithymia Scale (TAS-20), Rapid Stress Assessment Scale (RSAS), Morisky Medication Adherence Scale (MMAS-4), Visual Analogic Scale (VAS) and a questionnaire regarding the economic healthcare spending in the last 12 months were administered. The correlation analysis showed that anxiety and social support scores (RSAS) were significantly related to Morisky Medication Adherence scores (r=-.26 p=.035; r=.27 p=.028). Mathematical linear regressions models confirmed the predictive effect of anxiety and social support (RSAS) on Morisky Medication Adherence scores. Moreover, medication adherence was significantly correlated to anxiolytics use (r=-.26 p=.040) and the mathematical linear regressions models showed a predictive effect of adherence scores on anxiolytic use. Finally, anxiety, depression and aggressiveness scores (RSAS) were related to the number of general check-up (r=.31 p=.013; r=.38 p=.002; r=.43 p<.001). TAS-20 total and TAS-20 F3 were positively correlated with the number of hospitalization days (r=.41 p=.001; r=.31 p=.011), while physician-patient communication (IPC) showed a negative correlation to the number of hospitalization days (r=-.35 p=.005). Future studies should test whether brief psychological intervention may increase the adherence and reduce the healthcare spending in diabetic patients.