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Respondents’ level of adherence towards antidiabetic medications among type II diabetic patients in GUH, Diabetic Clinic, Northwest Ethiopia, 2013.
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. The prevalence of diabetes mellitus (DM) is rising worldwide and is more in the developing countries which unfortunately are already suffering from communicable diseases. The aim of this study was to assess adherence and associated factors towards antidiabetic medication among type II diabetic patients in University of Gondar Hospital, Diabetic C...
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Introduction:
Adherence to lifestyle modification in addition to medication adherence is very important in preventing complications. Nevertheless, lifestyle modification guidelines are not widely followed by patients with hypertension. The objective of the study was to explore the predictors of compliance with lifestyle modification among patients...
Citations
... Research has shown that diabetes type 2 is more prevalent among individuals aged 51-60 years (26.9%) [22]. Consistent with the current study, the majority of participants (73.3%) were between the ages of 51 and 65. ...
... Research has shown that diabetes type 2 is more prevalent among individuals aged 51-60 years (26.9%) [22]. Consistent with the current study, the majority of participants (73.3%) were between the ages of 51 and 65. ...
The study aims to assess the knowledge, attitudes, and practices of type 2 diabetes patients at Hoima Regional Referral Hospital, Uganda, regarding adherence to anti-diabetic medication. The majority of participants (73.3%) were between the ages of 51 and 65. 80% of the participants in the study were women, consistent with previous studies. Religion can influence adherence to treatment, as it can discourage harmful practices like drinking or smoking. Catholics and Protestants made up the majority of the participants (73%). The study found that about 23.3% of participants reported not exercising at all, while half claimed to exercise once or twice a week. The study found that patients' knowledge score on diabetes medication usage is generally good, but the adherence practice of patients in the current study was suboptimal. Factors influencing adherence to diabetes treatment include affordability, clinic attendance, education level, waiting time, and accessibility. A majority of patients (86.7%) reported that inaccessibility to the hospital and long waiting times at the hospital negatively affect their compliance. Health service factors such as regular attendance at diabetes clinics, health education sessions, and improved knowledge about their condition can help patients adhere to treatment recommendations. Work, home, and hospital environmental settings also affect drug compliance. Occupation may influence adherence to treatment, as having time to see a physician on appointed dates for drug refills and some occupations predispose individuals to behaviors that oppose treatment adherence. Recommendations include government creating income-generating activities for individuals with chronic illnesses like diabetes mellitus, conducting adherence campaigns through local media, improving clinic setups, and conducting more research on factors influencing adherence to diabetes treatment recommendations in other parts of Uganda. INTRODUCTION Diabetes mellitus (DM) is a major public health issue globally [1]. Current estimates indicate that nearly 415 million people are affected and is set to escalate to 642 million by the year 2040, with a further 193 million people with diabetes remaining undiagnosed due to the often mild or asymptomatic nature of this condition, especially in type 2 DM (T2DM) [2,3]. Type 2 diabetes occurs when the body is not able to produce enough insulin to enable it to function properly, or the body's cells do not react to insulin. This means that glucose remains in the blood and is not used as fuel for energy. By the year 2014, the global prevalence of diabetes was estimated to be 9% among adults aged 18 years and above [4, 5]. Internationally, in 2012, an estimated 1.5 million deaths were directly caused by diabetes, whereas more than 80% of diabetes deaths occur in low-and middle-income countries. According to WHO [1], it is projected that diabetes was the seventh leading cause of death in 2030. The incidence of diabetes, especially type 2, is rapidly growing in the world. In 1985, an estimated 30 million people suffered from this chronic disease, which, by the end of 2006, had increased to 230 million, representing 6% of the world population. Of this number, 80% is found in the developing world, of which 4% had diabetes mellitus. It is estimated that, during the next 35 years, diabetic worldwide prevalence will reach 25%, with India being the hardest hit. By 2025 [6] it is estimated that more than 75% of people with diabetes will reside in low-income countries. Uganda is experiencing a marked upsurge of diabetes. In a random sample from Kampala, the capital city, and its neighboring district Mukono, the prevalence was estimated to be up to 8.1% [7]. A key dimension of healthcare quality is adherence to prescribed medications. According to the World Health Organization (WHO), adherence is the extent to which a person's behavior, such as taking medication, following a prescribed diet,
... This problem might be severe in chronic illnesses and patients with comorbidities because of increased medication costs for treating additional conditions. Particularly in Ethiopian settings, most patients are of low socioeconomic status (67,68). On the contrary, most patients with chronic diseases have comorbid conditions and receive multiple medications (36)(37)(38)(39). ...
Background
Medication regimen complexity (MRC) is suspected to hinder medication adherence in patients with multiple illnesses. Despite this, the specific impact on Ethiopian patients with multimorbidity is unclear. This study assessed MRC and its impact on medication adherence in patients with multimorbidity.
Methods
A hospital-based cross-sectional study was conducted on patients with multimorbidity who had been followed at the University of Gondar Comprehensive and Specialized Hospital (UoGCSH), Ethiopia, from May to July 2021. Medication complexity was measured using the validated Medication Regimen Complexity Index (MRCI) tool, and the Adherence in Chronic Diseases Scale (ACDS) was used to measure medication adherence. Pearson’s chi-square test was used to examine associations between MRCI levels and medication adherence. Ordinal logistic regression analysis was used to determine the impact of MRC and other associated variables on medication adherence. Statistical significance was determined using the adjusted odds ratio (AOR) at p-value <0.05 and its 95% confidence range.
Results
Out of 422 eligible patients, 416 (98.6%) were included in the study. The majority of participants (57.2%) were classified as having a high MRCI score with a mean (±SD) score of 9.7 (±3.4). Nearly half of the patients (49.3%) had low medication adherence. Patients with medium (AOR = 0.43, 95% CI: 0.04, 0.72) and higher (AOR = 0.31, 95% CI: 0.07, 0.79) MRCI levels had lower odds of medication adherence. In addition, monthly income (AOR = 4.59, 95% CI: 2.14, 9.83), follow-up durations (AOR = 2.31, 95% CI: 1.09, 4.86), number of medications (AOR = 0.63, 95% CI: 0.41, 0.97), and Charlson comorbidity index (CCI) (AOR = 0.36, 95% CI: 0.16, 0.83) were significantly associated with medication adherence.
Conclusion
Medication regimen complexity in patients with multimorbidity was found to be high and negatively impacted the levels of medication adherence. Healthcare providers and other stakeholders should seek interventions aimed at simplifying drug regimen complexity and improving adherence.
... Another reason for non-adherence to anti-diabetic medicines is literacy and attending higher education because the prevalence was much higher in rural areas, where most of their residents were illiterate people [21,22]. A study defined a lack of knowledge and awareness of diabetes as contributing to drug adherence [23]. ...
Background: Treatment adherence is a primary key in controlling diabetes disease. The study aims to determine the prevalence of treatment adherence in type 2 diabetes mellitus (T2DM) patients, investigate the potential influence of adherence on elevated blood glucose levels, and identify the key factors which play a role in non-adherence to the prescribed drugs.
Method: A cross-sectional study method was utilized to collect data from all T2DM patients at the Diabetic and Endocrine Centre and Shar Hospital in Sulaymaniyah city in the Kurdistan region of Iraq from February 2022 to April 2022. The data collection was performed through a structured questionnaire. The prevalence of drug adherence was assessed using the Morisky Medication-Taking Adherence Scale (4-item), and the glycated hemoglobin test (A1C) was used to determine the blood glucose level.
Result: A total of 300 participants were studied, and more than half of them (192; 64%) revealed that they did not adhere to their anti-diabetic medications. Non-adherence was significantly associated with higher A1C. Several barriers to non-adherence were identified as multiple medications, feeling the dose given is high, lack of finance, and side effects by 209 (70%), 116 (39%), 113 (38%), and 103 (34%), respectively.
Conclusion: The current study's result revealed that most T2DM patients have no adherence to their medication. This non-adherence is significantly linked to higher A1C levels, emphasizing the critical role of medication compliance in managing diabetes effectively. The study also sheds light on the multiple barriers such as taking multiple prescriptions, the perception that the dose is excessive, lack of finances, and experiencing side effects, which contribute to non-adherence among diabetes patients. These findings underscore the need for healthcare providers to address these barriers and develop tailored strategies to enhance medication adherence among individuals with diabetes.
... Ethiopia, and the Oromia region, West Ethiopia (19,34). This suggests that patients who have education might adhere to their medications more closely since they are more informed about their medical conditions. ...
Background
Chronic heart failure affects around 26 million people globally. World Health Organization data shows only about half of chronically ill patients in developed countries adhere to recommended medication, with even lower rates in developing countries. Medication adherence is critical for managing chronic heart failure affects symptoms, delaying disease progression, and preventing hospitalizations. However, poor adherence leads to increased re-hospitalizations, morbidity, mortality, and healthcare costs.
Objective
To assess medication adherence and its associated factors among chronic heart failure patients on follow-up at North Shewa public hospitals, Oromia Region, Ethiopia, in 2023.
Methods
An institutional-based cross-sectional study design was conducted from March 1 to April 30 2023 G.C. A total of 603 sample size were selected consecutively among those coming for chronic OPD after being proportionally allocated to five hospitals in the zone. Data were collected using an interviewer-administered questionnaire and a medical chart review. Data were entered into Epi-data version 3.1, then exported to SPSS version 26 for analysis. Variables with a P value < 0.25 in the bivariate analysis were included in the multivariate logistic regression model. The degree of association was expressed using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) at a P value < 0.05
Result
Among 603 patients, 56% had optimal medication adherence with 95% CI: (52.1, 60). Being able to read and write (AOR: 2.20; 95% CI: 1.34, 3.61), having a secondary education (AOR: 1.97; 95% CI: 1.06, 3.67), having community-based health insurance (AOR: 1.82; 95% CI: 1.22, 2.71), not having co-morbidity (AOR: 1.82; 95% CI: 1.18, 2.52), taking a number of drugs < 2 (AOR: 2.11; 95% CI: 1.20, 2.45), not adding salt when cooking (AOR: 1.72; 95% CI: 1.20, 2.45), and asking a doctor or nurse without fear (AOR: 1.87; 95% CI: 1.03, 3.40) were factors associated with medication adherence among CHF.
Conclusion
This study found 56% of chronic heart failure patients had optimal medication adherence. Factors associated with higher adherence included higher education, community health insurance, lack of comorbidities, fewer medications, avoiding added salt, and comfort communicating with providers. Health professionals should provide education to strengthen medication adherence.
... This finding reveal that those who had member of diabetic association were less likely to have good self-care practice than those did not have member of diabetic association. This finding was comparable with the study conducted in Gondar, northern Ethiopia where patients with member of diabetic association were more likely to have good self-care [17]. Individual who were knowing FBS were two times more likely to have good self-care practice than those who had not knowing their FBS. ...
... In table 2, it shows that 53.3% of patients used combination of two antidiabetics, so it was possible that patients with this combination showed the highest adherence. Demographic characteristics including gender, age, duration of disease, education, and complications also affect medication adherence (Abebaw et al., 2016;Petrenchik & Loh, 2020). Although the results showed that there was no significant association, the results in table 4 illustrate the influence between antidiabetic usage pattern and medication adherence. ...
Background: Type 2 diabetes mellitus (DM) is a chronic disease which requires long-term therapy. Medication adherence plays an important role for therapeutic success in patients with T2DM. Antidiabetic usage pattern might involve with some problems related to medication adherence. Objectives: The aim of this study was to analyze the association between antidiabetic usage pattern with medication adherence. Material and Methods: This observational study was conducted cross-sectionally involving 90 participants of T2DM outpatient at Private Hospital in Buleleng Bali during July-September 2020. Patients were included if aged ≥18 years, received the same antidiabetic for three months before the study, signed informed consent, and provided with complete medical record data. Patients were excluded if appeared to be unwell, pregnant or breastfeeding. Demographic data and antidiabetic usage patterns were collected retrospectively based on the patient's medical records. Probabilistic Medication Adherence Scale (ProMAS) questionnaire was used to assess medication adherence. Data were analyzed with Kruskal-Wallis test. Results: The results showed that 55.6% patients were male, aged 46-65 years (61.1%), education predominantly by elementary school (37.8%), had suffered from DM for 5-10 years (46.7%), with comorbidities (50%), and without complications (77.8%). The antidiabetic usage pattern was dominated by a combination of two antidiabetics (53.3%). Most patients (42.2%) showed moderate-high medication adherence. There was no statistically significant association between antidiabetic usage pattern and medication adherence (p=0.275). Conclusions: A higher rate of medication adherence was found in patients taking combination of two antidiabetics compared to combination of three or four antidiabetics.
... Various studies have explored adherence to antidiabetic medications with different results. In several studies conducted in the United Arab Emirates (UAE), Ethiopia and Uganda, and Kingdom of Saudi Arabia the prevalence of adherence to antidiabetic medications was about 85% (Abebaw et al., 2016;Alakhali, 2015;Arifulla et al., 2014;Bagonza et al., 2015). On the other hand, studies conducted in Cameroon and Switzerland showed lower prevalences, ranging from 40% to 52% (Aminde et al., 2019;Huber & Reich, 2016). ...
Poor adherence to antidiabetic medication, which causes diabetes-related complications and increases medical burden, has been an important concern for both patients and physicians. Enhancing patients' beliefs about medicine can partially improve their non-adherence status to medications. To evaluate the factors associated with beliefs about antidiabetic medicine in outpatients with type 2 diabetes at Hue University Hospital. A cross-sectional study was conducted on 396 outpatients diagnosed with type 2 diabetes mellitus at the Endocrinology Clinic at Hue University Hospital. We interviewed the patients using a questionnaire based on the Vietnamese version of the Beliefs about Medicines Questionnaire (BMQ-V). The study was conducted on 396 patients with type 2 diabetes, with a median age of 66.9 ± 13.7 years. The prevalence of outpatients achieving HbA1C and glycemic targets was 18.7% and 20.7%, respectively. According to the BMQ-V questionnaire, the participants’ beliefs about medicine had a mean score of 50.3 ± 8.1. The mean value of the Specific-Concerns subscale was the highest (14.5 ± 3.8) and the Specific-Necessity subscale was the lowest (9.8 ± 3.9). Multivariate regression analysis revealed a statistically significant association between BMQ score and HbA1c control status, duration of diabetes, and home blood glucose monitoring (p < 0.05). Coordination between clinical pharmacists and physicians should be strengthened to improve their positive beliefs and gradually reduce their negative beliefs about medicines, thereby increasing medication adherence and improving treatment effectiveness.
... These characteristics are important determinants and influential factors that can impact how successfully a patient comprehends and adheres to their medication and selfcare practice (22). Age (23)(24)(25)(26)(27), gender (28,29), education (27,29,30), and occupation (25,28) are some of the commonly cited social-demographic factors. The WHO has identified four additional factors and socialdemographic variables that are likely to contribute to non-adherence. ...
... These include; patient-related, condition-related, therapy-related, and healthcare /system-related factors (31). Patient-related factors frequently cited include forgetting to take medication/s (26,28,(32)(33)(34)(35), stopping taking medication/s either when feeling well (36) or felling worse (23), and lack of finance (33,35,(37)(38)(39)(40). Condition-related factors have also been reported as the duration of having the disease (24,30), associated comorbidities (41,42), and taking other medications (25). Therapy-related factors such as side effects (26,36,37,40,41,43) and medication cost (24,36,44) were commonly associated with non-adherence. ...
Influential factors causing poor adherence to antidiabetic medications and self-care practices among type 2 diabetes mellitus (T2DM) patients have not been reported before in Libya. To assess such factors that contribute to non-adherence, a single health facility, cross-sectional descriptive study was carried out on T2DM patients attending the NCDE in Tripoli/ Libya; using a pre-tested questionnaire. Crude odds ratios in the binary logistic regression were used to describe the associations between medication adherence and various independent factors using SPSS version 26. Adjusted odds ratios with their corresponding 95% confidence intervals were further generated in the multivariable analysis, to determine variables which were independently associated with medication adherence and were considered significant at a p-value of <0.05. Of the 380 study participants, only 225(67.1%) were adherent. 159(41.8%) were non-adherence to physician recommendations and were careless when taking their medication, 200(52.6%) found difficulty maintaining recommended dietary restrictions, 211(55.5%) and 97(25.5%) didn't adhere to regular exercise or blood glucose monitoring; respectively. Factors significant association with non-adherence were; medication being taken; especially patients who were prescribed OHA and insulin ([AOR] [95% CI] = 0.214[0.073-0.632]), being careless and not taking prescribed medication as recommended ([AOR] [95% CI] = 2.880 [1.387-5.983]), forgetfulness ([AOR] [95% CI] =0.199 [0.070-0.570], stop taking prescribed antidiabetic medication when feeling well ([AOR] [95% CI] = 0.153[0.058-0.402], medications side effects ([AOR] [95% CI]=0.382 [0.181-0.809] and unawareness of the consequences of not adhering to medication as recommended and the consequences skipping doses ([AOR] [95% CI] = 0.146 [0.037-0.581]). Adherence to recommended medication and self-care practices in Libya is unsatisfactory. Diabetes education, awareness programs, and regular monitoring of T2DM individuals' medication adherence and self-care practices are vitally required.
... According to age, our study showed that younger patient had higher level of non-adherence, as increase in age is associated with increased adherence level, that is agreement with another study which showed that non-adherence was largely by younger patients [20] and that was related to inadequate disease knowledge, perceived less severity of disease, fear of new disease or side effect of their treatment [21]. As a person gets older, he becomes more aware of the severity of a disease and the importance of controlling blood glucose level to reduce complications of the disease and also obtain family support for managing his diabetes [22]. But when the patient arrives at the age of 70 years, this association may be reduced because of some aging process like cognitive impairments [23]. ...
Aim. This study was aimed to assess the level of medications adherence and to identify factors that are associated with non-adherence to anti-diabetic medications among patients with type 2 diabetes mellitus in Al-Bayda-Libya. Methods. A cross-sectional study was conducted from April to August 2022 at Diabetes Center Aljabal Al-akhdar in Al-Bayda, Libya. A total of 300 patients with type 2 diabetes mellitus. Adherence was measured by using the Medication Compliance Questionnaire. Other data, such as age, gender, BMI, duration of diabetes, comorbidities, number of drug taken, medication knowledge, and pattern of antidiabetic medication were also collected. The data analysis was carried out using Statistical Package for Social Science (SPSS) for Windows version 26.0. Results. Out of 300 patients, about 169 (56.3%) were not adherent to obtain their medication properly. When we assessed the variables to predict factors that associated with non-adherence by using Logistic regression analysis, we found only three factors: age CI (0.940-0.985); P=0.043, medication knowledge CI (0.950-0.984); P=0.018, and pattern of anti-diabetic medication CI (0.945-0.955); P=0.034. Conclusion. Our findings showed that the adherence to type 2 diabetic medication was poor with more than half of participants being non-adherent. This is a cause of alarm, because non-adherence could lead to a worsening of disease. Educating patients about their medication could help improve adherence.
