Association of Disease Knowledge and Medication Adherence Among Out-Patients With Type 2 Diabetes Mellitus in Khobar, Saudi Arabia

Abstract

Objective: The study aimed to evaluate the association between disease knowledge and medication adherence in patients with type 2 diabetes mellitus. Methods:A cross-sectional study was conducted for three months, in patients with type 2 diabetes who visited three community pharmacies located in Khobar, Saudi Arabia. Patients' disease knowledge and their adherence to medications were documented using Arabic versions of the Michigan Diabetes Knowledge Test and the General Medication Adherence Scale respectively. Data were analyzed through SPSS version 23. Chi-square test was used to report association of demographics with adherence. Spearman's rank correlation was employed to report the relationship among Hb A1c values, disease knowledge and adherence. Logistic regression model was utilized to report the determinants of medication adherence and their corresponding adjusted odds ratio. Study was approved by concerned ethical committee (IRB-UGS-2019-05-001).Results: A total of 318 patients consented to participate in the study. Mean Hb A1c value was 8.1%. A third of patients (N = 105, 33%) had high adherence and half of patients (N = 162, 50.9%) had disease knowledge between 51% -75%. A significantly weak-tomoderate and positive correlation (r = 0.221, p < 0.01) between medication adherence and disease knowledge was reported. Patients with >50% correct answers in the diabetes knowledge test questionnaire were more likely to be adherent to their medications (AOR 4.46, p < 0.01).Conclusion: Disease knowledge in most patients was average and half of patients had high-to-good adherence. Patients with better knowledge were 4 to 5 times more likely to have high adherence. This highlights the importance of patient education and awareness regarding medication adherence in managing diabetes.

Translation and validation of the Arabic version of the General Medication Adherence Scale (GMAS) in Saudi patients with chronic illnesses

“…Available evidence highlights that adherence has been reported to be associated with pill burden ( Scott Sutton et al, 2016 ). It was reported that Saudi patients who were prescribed with ≤2 medicines had better adherence ( AlShayban et al, 2020 ). In this study the correlation between adherence score and pill burden was weak-to-moderate and significant, that was enough to establish construct validity of the tool.…”

“…Based on previous findings, it was hypothesized that patients with better employment status and monthly family income were more likely to be adherent ( AlShayban et al, 2020; Alqarni, 2019 ). This hypothesis was tested as a proxy for known group validity.…”

“…It was assessed through a multivariate logistic regression model to evaluate determinants of medication adherence. The model was adjusted for patients’ demographic variables, Available evidence highlighted that monthly family income and comorbidity status were linked to adherence ( AlQarni et al, 2019 , AlShayban et al, 2020 ). In addition, we tested other demographic and related variables in the model.…”

“…Within Saudi Arabia, a study conducted among a large patient cohort in Riyadh reported that 42.8% had poor adherence to oral antidiabetic medications ( Balkhi et al, 2019 ). In two studies conducted in Khobar, unsatisfactory adherence in over 40% of out-patients with type 2 diabetes was reported ( AlQarni et al, 2019 , AlShayban et al, 2020 ). Poor adherence was also reported among hypertensive patients (55%) ( Shaik et al, 2016 ).…”

“…Many studies have been conducted to assess medication adherence among Saudi patients ( Balkhi et al, 2019 , AlQarni et al, 2019 , AlShayban et al, 2020 ). A novel scale termed as the General Medication Adherence Scale (GMAS) was developed and validated in Urdu and English languages in Pakistan; a country with similar culture as Saudi Arabia ( Naqvi et al, 2018 , Naqvi et al, 2019a ).…”