Barriers to diabetes medication adherence in North West Ethiopia

Abstract

BackgroundLow adherence to prescribed diabetes medications is one of the major reasons to poor glycemic control in developing countries. Therefore, this study attempted to assess the magnitude of medication adherence and factors associated with it among adult persons with diabetes in northwest Ethiopia.MethodThis study utilized a cross sectional study design with internal comparison. The study population was adult persons with diabetes attending the Diabetes Referral Clinic of Gondar University Hospital. Adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8). In addition laboratory tests and chart reviews were carried out to collect relevant data. Ordinary logistic regression was used to identify factors associated with adherence.ResultA total of 391 patients were studied. Based on the MMAS-8 scale, the self-reported adherence to diabetic medication was low for 25.4% [95% CI: 21, 29] of the patients, medium for 28.7% [95% CI: 24, 33], and high for 45.9% [95% CI: 41, 50] of the patients. The Mean (±SD) of glycosylated hemoglobin for the low adherence group was 8.2% (±2.1). It was 8.1% (±2.0), for the medium, and 7.4% (±1.6) for the high adherence group. In the multivariate analysis poor wealth status (AOR = 1.99; 1.15, 3.43), using traditional treatment (AOR = 2.90; 1.03, 8.15), and service dissatisfaction (AOR = 2.23; 1.04, 4.80) were significantly associated with low adherence to prescribed diabetic medications.ConclusionOver half of the persons with diabetes did not adhere to medications. Adherence was poor among users of traditional treatment and those dissatisfied with services. Developing a more intensive communication strategies and improving the quality of services could improve the level of adherence.

Levels and Predictors of Adherence to Self-care Behaviour among Adult Type 2 Diabetics at Arba Minch General Hospital, Southern Ethiopia

“…The finding of this study was similar to study done in Harari 39.3% of the study participants had good self-care practices [48]. However findings from study done in JUSH; 45% of the participants had Good self-care practice [40] and Nekemte Referral Hospital showed that; 45% of study participants had good self-care practices [9].…”

“…This is similar with study done in Nekemte Referral Hospital; Subjects earning relatively high average monthly income (750-1050) Birr were 5.6 times more likely to practice self-care than those earning less than 350 Birr [9] and study done in Harari; patients relatively in high income category can get healthy foods that are recommended for diabetic patients [48], high income was correlated with high self-care ability or low income was associated with low self-care ability than those middle and high income patients [91].…”

“…A similar study done in Harari, Ethiopia, showed that only 31.1% had exercise for thirty minutes per day [48]. The WHO has reported that as many as 50% of the patients with chronic diseases do not take their medications as prescribed [49].…”

“…Several studies which have assessed and managed diabetes in different countries, all indicate that diabetes management in different societies, even in developed countries is not desirable [70]. Similarly Studies conducted in Different Hospitals in Ethiopia have shown that glycaemic control is poor [48].…”

“…Number of days patient practiced specific behavior Self care behaviors mean score Total number of days under questions designed for that behavior = [9,48] and study done in JUSH, age is associated with self-care practices [40], study conducted in Thailand, age was an independent predictor of self-care practices [60] being young aged in Type 2 DM was associated with ability to shifting of view or mentality and motivation to engage in healthy lifestyles [91]. This could be attributed to lack of motivation and lack of social support in elderly individuals compared to young adults.…”