A study to assess the treatment adherence among patients with type 2 diabetes mellitus in rural and urban population of Bengaluru, South India
Keywords:Medication adherence, Rural and urban population, Type 2 diabetes
Background: Globally, around 425 million adults are victims of diabetes with increased prevalence being noted in low and middle income countries. Diabetes was seventh leading cause of death leading to 1.6 million deaths in 2016 (WHO report). Management of diabetes is multifaceted which includes diet, physical activity, screening for complications and medications. Adherence to pharmacotherapy plays an important role in glycemic control. Hence, this study was done to assess the magnitude of treatment adherence and its associated factors among type 2 diabetics.
Methods: A community based study was done on patients with type 2 DM in the rural and urban population of Bengaluru. A simple random sampling technique was followed. Medication adherence was assessed using 8 item Morisky's treatment adherence scale.
Results: A total of 250 subjects were interviewed, among them 59% were male and 41% were female. The mean age of the subjects was 60.93±10.1 years. The mean treatment adherence scores was 25.9±3.1 years. Among the 250 diabetics, 62% were adherent and 38% were non adherent to anti diabetic medications. Forgetfulness to take medications was one of the reasons for non-adherence with mean scores of 3.12+0.6.Being illiterate, labourers, aged above 60 years, obesity, frequency and multiple dosage was found to be significant factors for non-adherence (p<0.05).
Conclusions: Adherence to anti diabetic drugs was found to be 62%. Increased age, illiteracy, occupation, BMI, frequency and multiple doses of drugs were significant factors responsible for medication non adherence. There is a need for reinforcement of health education and motivation for diabetics to improve their medication adherence.
Diabetes Factsheet. World Health Organization. 2018. Available at: https://www.who.int/news-room/fact-sheets/detail/diabetes
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487-97.
Kavitha S, Nalini GK, Suresh RM, Sahana GN, Deepak P, Nagaral JV. Treatment adherence and factors contributing to non adherence among type 2 diabetes mellitus patients in a tertiary care hospital: a cross sectional study. Int J Basic Clin Pharmacol. 2017;6:689-94.
Abebaw M, Messele A, Hailu M, Zewdu F. Adherence and associated factors towards antidiabetic medication among type II diabetic patients on follow-up at University of Gondar Hospital, Northwest Ethiopia. Adv Nurs. 2016:2016.
Sharma T, Kalra J, Dhasmana D, Basera H. Poor adherence to treatment: A major challenge in diabetes. J Indian Acad Clin Med. 2014;31(40):40.
IDF Diabetes Atlas. International diabetes federation. 8th edition. Available at: http://www.diabetesatlas.org. Accessed on 16 December 2019.
Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of self-reported measure of medication adherence. Med Care. 1986;24(1):67-74.
Wabe NT, Angamo MT, Hussein S. Medication adherence in diabetes mellitus and self management practices among type-2 diabetics in Ethiopia. North Am J Med Sci. 2011;3(9):418.
Rwegerera GM, Moshomo T, Gaenamong M and Ogewo TA et al. Antidiabetic medication adherence and associated factors among patients in Botswana; implications for the future. Alexandria J Med. 2018;54 (2).
Jemal A, Abdela J, Sisay M. Adherence to oral anti diabetic medications among type 2 diabetic (T2DM) patients in chronic ambulatory wards of Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia: a cross sectional study. J Diabetes Metab. 2017;8(1):721.
Venkatesan M, Dongre AR, Ganapathy K. A community‑based study on diabetes medication nonadherence and its risk factors in rural Tamil Nadu. Indian J Community Med. 2018;43(2):72-6.
Aminde LN, Tindong M, Ngwasire CA, Aminde JA, et al. Adherence to antidiabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocr Disord. 2019;19:35:1-9
Abate TW. Medication non-adherence and associated factors among diabetes patients in Felege Hiwot Referral Hospital, Bahir Dar city administration, Northwest Ethiopia. BMC Res Notes. 2019;12:1-6.
Hashimoto K, Urata K, Yoshida A, Horiuchi R, Yamaaki N, Yagi K, et al. The relationship between patients’ perception of type 2 diabetes and medication adherence: a cross-sectional study in Japan. J Pharm Health Care Sci. 2019;5(1):2.