Assessment of Medication Adherence and Associated Factors Among Patients With Diabetes Attending a Non-communicable Disease Clinic in a Community Health Centre in Eastern India

Abstract

Background Non-adherence to medication represents a modifiable risk factor for patients with type 2 diabetes mellitus (T2DM). Identification of patients with poor adherence can have a significant impact on clinical and socio-economic outcomes in the management of diabetes. This study aimed to assess medication adherence and its associated factors among patients with T2DM attending a non-communicable disease (NCD) clinic in a rural community health centre (CHC) in eastern India. Methods The study was a facility-based study that included 207 study participants with an age greater than 18 years. A structured questionnaire was used to collect data on socio-demographic characteristics, health-seeking behaviour, self-care practices, risk factors, clinical information on diabetes, prescription practices, and medication practices. The Hill-Bone Medication Adherence Scale (HB-MAS) has been used to assess medication adherence among study participants. Results The study found that the medication adherence rate among the study participants was 67.1%. On multivariate analysis, subjects with social insurance (adjusted odds ratio (AOR) = 2.73, 95% confidence interval (CI) = 1.01-7.38, p-value = 0.047), current smoking status (AOR = 5.47, 95% CI = 1.55-19.23, p-value = 0.008), anxiety (AOR= 3.52, 95% CI= 1.62- 7.61, p-value= 0.001), polypharmacy (AOR= 3.79, 95% CI= 1.25- 11.45, p-value= 0.018), and using alternative medicine (AOR= 5.82, 95% CI= 1.58 - 21.39, p-value= 0.008), were found to have a significantly higher chance of non-adherence. On the other hand, patients practising regular physical activity (AOR = 0.31, 95% CI= 0.12-0.79, p-value = 0.015) and with deprescription (AOR = 0.12, 95% CI= 0.03-0.47, p-value = 0.002) were found to have less chance of non-adherence as compared to their counterparts. Conclusion The study highlights the need to identify patients with poor medication adherence and develop interventions according to their requirements through a holistic approach. The study contributes to the existing literature on medication adherence among diabetes patients in rural healthcare settings in eastern India.