Abstract
BackgroundDiabetes is a chronic medical condition and adherence to medication in adults with diabetes is important. Identifying predictors to medication adherence in adults with diabetes would help identify vulnerable patients who are likely to benefit by improving their adherence levels.MethodsWe conducted a cross-sectional study at the Dubai Police Health Centre between February 2015 and November 2015. Questionnaires were used to collect socio-demographic, clinical and disease related variables and the primary measure of outcome was adherence levels as measured by the Morisky Medication Adherence Scale (MMAS-8©). Multivariate logistic regression was carried out to identify predictors to adherence.ResultsFour hundred and forty six patients were interviewed. Mean age 61 year +/− 11. 48.4 % were male. The mean time since diagnosis of diabetes was 3.2 years (Range 1–15 years). Two hundred and eighty eight (64.6 %) patients were considered non-adherent (MMAS-8© adherence score < 6) while 118 (26.5 %) had moderate adherence (MMAS-8© adherence score 6 = <8) and 40 (9.0 %) high adherence (MMAS-8© adherence scores <8) to their medication respectively. The strongest predictor for adherence as predicted by the multi-logistic regression model was the patient’s level of education. A technical diploma certificate as compared to a primary school level of education was the strongest predictor of adherence (OR = 66.1 CI: 6.93 to 630.43); p < 0.001). The patient’s age was also a predictor of adherence with older patients reporting higher levels of adherence (OR = 1.113 (CI: 1.045 to 1.185; p = 0.001 for every year increase in age). The duration of diabetes was also a predictor of adherence (OR = 1.830 (CI: 1.270 to 2.636; p = 0.001 for every year increase in the duration of diabetes). Other predictors to medication adherence include Insulin use, ethnicity and certain cultural behaviours.ConclusionA number of important predictors to medication adherence in diabetics were identified in this study. Such predictors could help develop policies for improving adherence in diabetics.
Highlights
Diabetes is a chronic medical condition and adherence to medication in adults with diabetes is important
Several studies have been carried out looking at medication adherence in diabetic patients around the world; no studies have been performed in the U.A.E [11,12,13]. Study design This was a cross-sectional study looking at predictors to medication adherence among diabetics as measured by the Morisky Medication adherence scale (MMAS-8©)
More than a third (39.5 %) of the participants reported that sometimes they forgot to take their anti-diabetic medications; 37.9 % reported that they did not take their medications on at least one occasion in the two weeks before the interview; 33.4 % reported that they discontinued taking their medications without telling their
Summary
Diabetes is a chronic medical condition and adherence to medication in adults with diabetes is important. The UAE was ranked as the 19th highest income countries of the world in 2012 (International Monetary Fund) and is categorized as a high income country according to the (World bank, 2012). This has led to a more affluent lifestyle, and from health point an increase in total calorie intake per person together with a decrease in calorie expenditure. This has led to a nationwide obesity pandemic with the rates of obesity climbing to record highs and standing at about 68 % of the population according to one estimate from 2007
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