Adherence to Treatment in Patients with Type 2 Diabetes Mellitus

Abstract

BACKGROUND: Adherence to medications is an important factor in effective prevention of diabetes complications. Assessment of treatment adherence is necessary for the effective treatment planning. This study was undertaken with the objective of assessing adherence to diabetes medications, association between adherence & glycemic control and factors affecting the poor adherence among the Type 2 DM patients. METHODOLOGY: A total of 236 diabetic patients were included in this cross sectional study. The required sample was obtained by simple random sampling from line listing of diabetic cases in the study area. Patients above the age of 18 years diagnosed with type 2 DM & on regular treatment for at least one year were included in the study. Glycemic control was assessed by the measuring glycated hemoglobin (A1C) value. RESULTS: The overall prevalence of poor adherence to diabetic medications i.e. brief medication adherence score ≥ 1 among the participants was 58.89%. There was a significant association between poor diabetic medication adherence level and their glycemic status. The majority of nonadherent patients (62.58%) had poor glycemic control state as compared to adherent patients (37.42%). Although female, frequent change in drug regimen, higher annual direct cost expenditure had higher percentages of poor medication adherence, none of these variables significantly related to poor medication adherence. However, it was found that education ≤10 years of schooling , duration of disease ≥5 years , frequency of dosing thrice daily and presence of other co-morbidities were significantly related to a low adherence level. CONCLUSION: A high percentage of the study population was poorly adherent to the diabetic medication. A more concerning fact was the significant association of the non-compliance with poor glycemic control, which emphasized the role of a repeated patient education regarding drug adherence.