An evaluation of patients’ adherence with hypoglycemic medications among Papua New Guineans with type 2 diabetes: influencing factors

Abstract

PurposeThe aims of this study were to evaluate the extent of adherence to hypoglycemic medications, assess the relationship between adherence and glycemic control, and evaluate factors affecting adherence.Research design and methodsThis was a cross-sectional study of patients with established type 2 diabetes attending the Port Moresby General Hospital Diabetes Clinic. Face-to-face interviews were conducted using a questionnaire designed for the study and data were collected concerning the 3 months prior to interview. The questionnaire covered demographic details, lifestyle, biochemical and physical measurements, and medication management. Glycemic control was investigated among patients adhering to their medications (not missing doses) to different degrees (100%, 95%, 90%, and 80%).ResultsOf a total of 356 participants who were prescribed hypoglycemic medications, 59.6% omitted some of their doses. Age appeared to have a significant impact on adherence at some levels of adherence, with those aged >60 years being more likely to be adherent (logistic regression). Those who were 95%–99% and those who were <80% adherent had a statistically significant risk of a high glycated hemoglobin of >10% (85.5 mmol/mol). Multiple factors were identified as contributors to nonadherence, with patient-based issues (86.0%) and the health care system (21.7%) being the most common.ConclusionThis study showed a significant level of nonadherence among patients with type 2 diabetes in Papua New Guinea. Nonadherence to medication appeared to be associated with poor glycemic control and was due to a variety of reasons. Future interventions aimed at improving adherence will need to take these into account.

Association between patients&#39; beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

“…A study in Australia showed that 59.6% of patients omitted their hypoglycemic drugs 3 months before the study interview. 4 Another study, in the US, found that overall adherence to oral medications for military veterans with diabetes ranged from 42.5% to 54.1%. 5 Since treatment regimens will not work effectively if medications are not taken as prescribed, it is essential to pinpoint the causes for poor medication adherence, as well as intervention approaches to ensure optimal adherence.…”

Adherence to Antidiabetic Medications Among Sudanese Individuals With Type 2 Diabetes Mellitus: A Cross-Sectional Survey

“…Those who used herbal medicines for the treatment of their diabetes were 3.3 times more likely to be nonadherent to anti-diabetic medications, although this was insignificant. Many predictors of adherence have been reported including having taken medication for more than 3 years, availability of antidiabetic drugs, ever had diabetic education ( 16 ) and age >60 years ( 9 ). Several sociodemographic factors that significantly associated with poor adherence were age 45 years, non-European geographical origin, financial difficulties, and being professionally active.…”

“…Almobarak et al (2017) showed that the prevalence of diabetic foot in Sudan was around 18% ( 6 ), while retinopathy was reported to affect 78% of individuals with type 2 diabetes in Sudan ( 7 ). Importantly, several studies worldwide documented that the rates of adherence are suboptimal ( 8 - 13 ). Different factors have been associated with poor adherence including diabetes duration, inadequate patient education, side effects, the complexity of treatment regimen, unavailability of medicines, the high cost of medications, forgetfulness, and irregularity of follow-up ( 14 -17).…”

Factors associated with glycaemic control in patients with diabetes mellitus: A systematic literature review

“…The adults with type 2 DM who were 100% (OR: 1.87, p = 0.0081) and those who were 90% (OR: 2.02, p = 0.0353) adherent to hypoglycaemic medications had a statistically significant risk of a high HbA1c of >10% (875.5 mmol/mol; Pihau-Tulo, Parsons, & Hughes, 2014). Therefore, the prescription of a combination therapy indicated more aggressive treatment of glycaemic control due to deterioration of the disease (Amarasekara, Fongkaew, Wimalasekera, Turale, & Chanprasit, 2015).…”