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Discordant Medication Beliefs in Black Individuals With Mild Cognitive Impairment and Diabetes
Barry W Rovner1, Robin J Casten2
1Departments of Neurology (BWR), Psychiatry, and Ophthalmology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.
Objective:
To investigate the effects of discordant medication beliefs on diabetes self-management and glycemic control in older Black individuals with diabetes and Mild Cognitive Impairment (MCI).
Methods:
Cross-sectional analysis of baseline data from two clinical trials testing behavioral interventions to improve glycemic control in older Black primary care patients with diabetes and MCI.
Results:
The mean number of discordant medication beliefs was 6 (SD = 3; range 0 to 16). Sixty-seven of 246 (27%) participants held ≥ 9 discordant beliefs (i.e., one SD above the mean), and these participants had worse diabetes self-management and glycemic control than participants with fewer beliefs.
Conclusions:
Discordant medication beliefs, low adherence to diabetes self-management, poor glycemic control, and impaired cognition may exist in a causal relationship. Modifying discordant medication beliefs may eliminate the first step of this pathogenic sequence and reduce risk of cognitive decline in a high-risk population of older Black individuals with diabetes.
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