Abstract
Diabetes mellitus is a common problem in Saudi Arabia. Adherence to the pharmacological and lifestyle interventions regimens is essential for weight and glycaemic control, as well as prevention of co-morbidities. This study described the levels of treatment adherence among diabetes mellitus type II patients, explored the factors which influenced adherence and identified predictors of adherence. It was conducted in five ambulatory care clinics in the Western Region. The accessible population comprised diagnosed diabetes mellitus type II patients who received treatment at the ambulatory clinics. Persons aged ≥18 years and had been placed on medication and lifestyle intervention regimens at least six months prior to data collection, qualified for inclusion. The sample comprised 1,409 randomly selected participants. Participants completed a structured Arabic questionnaire, assisted by research assistants. The research assistants furthermore analysed the participants’ clinical records, using a structured checklist. Descriptive and inferential statistics were performed to quantify adherence, explore the relationships among variables and identify the predictors of adherence within the framework of the Health Belief Model. High prevalence of obesity and low prevalence of glycaemic control were found. Participants inadequately adhered to the medication and lifestyle intervention regimens, as well as blood glucose self-monitoring. The findings revealed various perceptual problems which might have contributed to inadequate adherence. The identified predictors of adherence indicated the essential requirements for health care interventions to improve treatment adherence. It is recommended that health education should address sociocultural in addition to biomedical matters to enhance the cultural congruency of interventions and ultimately adherence. Diabetes mellitus management aimed at achieving glycaemic and weight control and protection against co-morbidities requires health education, motivation and support targeted at medication and in particular lifestyle adherence.
Highlights
Prevalence and Contributing FactorsThe Kingdom of Saudi Arabia (KSA) has a total population of 27,345,986 (CIA, 2014)
Glycaemic control was measured using HbA1c results based on laboratory analysis of three millilitres of blood submitted in an EDTA tube
This study concludes that treatment adherence was inadequate despite participants’ appreciation for the benefits of adherence
Summary
The Kingdom of Saudi Arabia (KSA) has a total population of 27,345,986 (CIA, 2014). The prevalence of Diabetes Mellitus (DM) has reached epidemic proportions affecting an estimated 1.1 million adult (≥15 years) males and 775,000 females (MOH, 2014). DM and related co-morbidities constitute the leading cause of morbidity, disability and mortality. The estimated agestandardised death rate for DM and cardiovascular disease is 540.6 per 100,000 for males and 347.6 per 100,000 for females (WHO, 2011a). Inactivity and unhealthy eating patterns are related to obesity and DM (Badran and Laher, 2012; Lawrence et al, 2012). In the KSA, the main behavioural risk factor for chronic disease is physical inactivity and the main metabolic risk factor is overweight, followed by elevated
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