Treatment adherence and factors contributing to non adherence among type 2 diabetes mellitus patients in a tertiary care hospital: a cross sectional study
Keywords:Factors, Medication adherence, Type 2 Diabetes mellitus
Background: Diabetes mellitus (DM) is the most common endocrine disorder and major global public health problem. Lack of adherence to antidiabetic medication has lead to suboptimal blood sugar control, treatment failure, accelerated development of complications and increased mortality, thus medication adherence plays an important role in disease control. Hence present study was taken to evaluate the treatment adherence and factors affecting non adherence among Type 2 diabetes mellitus patients.
Methods: A cross sectional study carried out by Department of Pharmacology and Medicine, Hassan Institute of Medical Sciences, Hassan. Total 150 patients of type 2 diabetes were recruited after taking their informed consent. Adherence to treatment and factors associated with non adherence has been assessed during a personal interview with each patient using standardized questionnaire.
Results: Adherence levels were 28%, 42% and 30% for high, medium and poor adherence respectively. The overall prevalence of non adherence among respondents was 30%. Among them 77.77% were males, 44.44% belonged to age group of 41-60 years, 40% illiterate, 60% employed, 51.11% of patients with smoking and alcoholic habits were not adherent to anti diabetic treatment. Other reasons contributing to non-adherence to treatment were forget fullness (86.66 %), inadequate knowledge about side effects (80%), unhappy clinical visits (71.11 %) and lack of assistance (48.88 %).
Conclusions: Results showed that patients in the area of study were moderately adherent to anti-diabetic medications. This emphasizes the need for constant motivation and education at frequent intervals to ensure better adherence.
Diabetes Action online. World Health Organization; 1999. Available from: http://www.who.int/diabetes/action_online/basics/en/index.html. [Last accessed on 2016 July 20].
Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. AMJ. 2014;7(1):45-8.
Ciechanowski PS, Katon WJ, Russo JE, Walker EA. The patient-provider relationship: attachment theory and adherence to treatment in diabetes. American Journal of Psychiatry. 2001;158(1):29-35.
Garcı´a-Pe´rez LE , lvarez MA , Dilla T, Gil-Guille´n VG, Beltra´n DO. Adherence to Therapies in Patients with Type 2 Diabetes. Diabetes Ther. 2013;4:175-94.
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487-97.
Gerber BS, Cho YI, Arozullah AM, Lee SY. Racial differences in medication adherence: a cross-sectional study of Medicare enrollees. Am J Geriatr Pharmacother. 2010;8:136-45.
Walker EA, Molitch M, Kramer MK, Kahn S, Ma Y, Edelstein S, et al. Adherence to preventive medications: predictors and outcomes in the Diabetes Prevention Program. Diabetes Care. 2006;29:1997-2002.
Sankar UV, Lipska K, Mini GK, Sarma PS, Thankappan KR. The adherence to medications in diabetic patients in rural Kerala, India. Asia Pac J Public Health; 2013.
Kalyango J, Owino E, Nambuya A. Non-adherence to diabetes treatment at Mulago Hospital in Uganda: prevalence and associated factors. Afr. Health Sci. 2008;8:67-73.
Sakthong P, Chabunthom R, Charoenvisuthiwongs R. Psychometric Properties of the Thai Version of the 8-item Morisky Medication Adherence Scale in Patients with Type 2 Diabetes. The Annals of Pharmacotherapy. 2009 May;43:950-7.
Divya S, Nadig P. Factors contributing to non-adherence to medication among type 2 diabetes mellitus in patients attending tertiary care hospital in South India. 2015;8(2):274-76.
Morisky DE, Ang A, Krousel-Wood M, Ward H. Predictive validity of a medication adherence measure for hypertension control. J Clin Hypertens. 2008;10:348-54.
Jin J, Sklar GE, Sen Oh VM, Chuen Li S. Factors affecting therapeutic compliance: A review from the patient’s perspective. Therapeutics and Clinical Risk Management. 2008;4(1):269-86.
Heissam K, Abuamer Z, Dahshan N. Patterns and obstacles to oral antidiabetic medications adherence among type 2 diabetics in Ismailia, Egypt: a cross section study. Pan African Medical Journal. 2015;20:177.
Shobhana R, Begum R, Snehalatha C, Vijay V, Ramachandran A. Patients’ adherence to diabetes treatment. J Assoc Physicians India. 1999;47(12):1173-5.
Lertmaharit S, Kamol-Ratankul P, Sawert H. Factors associated with compliance among tuberculosis patients in Thailand. J. Med. Assoc. Thai. 2005;88:149-56.
Sajith M, Pankaj M, Pawar A, Modi A, Sumariya R. Medication adherence to antidiabetic therapy in patients with type 2 diabetes mellitus. International Journal of Pharmacy and Pharmaceutical Sciences. 2014;6(2):564-70.
Shams MEE, Barakat EAME. Measuring the rate of therapeutic adherence among outpatients with T2DM in Egypt. Saudi Pharmaceutical Journal. 2010;18:225-32.
Omar MS, San KL. Diabetes knowledge and medication adherence among geriatric patient with type 2 diabetes mellitus. Int J Pharm Pharm Sci. 2014;6(3):103-6.
Aghoja OC, Avwenaghagha HO, Ogba ER. Medication adherence and Its Correlates among Diabetic Patients in Central Hospital, warri, Nigeria. IOSR Journal of Pharmacy. 2016;6(3):96-103.
Martin LR, Williams SL, Haskard KB, Dimatteo MR. The challenge of patient adherence. Ther Clin Risk Manag. 2005;1(3):189-99.