<p>Medication Non-Adherence and Associated Factors Among Diabetic Patients Visiting General Hospitals in the Eastern Zone of Tigrai, Northern Ethiopia</p>

Abstract

Introduction Medication non-adherence is a major public health problem among diabetes mellitus patients. However, there is a lack of data regarding its magnitude and the factors contributing to Ethiopia’s non-adherence, especially in the Tigrai region. This study was conducted to assess the magnitude of non-adherence and its contributing factors among diabetes mellitus patients in the Eastern Zone of Tigrai, Northern Ethiopia. Materials and Methods A hospital-based cross-sectional study was conducted at Adigrat and Wukro General Hospitals using a pre-tested, self-administered, semi-structured questionnaire developed from the relevant literature and a checklist developed to review patient medical cards for the period of the 15th of March to the 15th of July, 2019. Data were analyzed using Statistical Package for Social Sciences version 20. Association between the dependent and the independent variable was performed using logistic regression and a p-value of <0.05 was considered significant. Results From a total of 321 study participants, 63.9% of the patients were non-adherent to their medications. Two-month dose issued on each visit (AOR = 2.865, 95% CI 1.380–5.949), dose issued for more than three months (AOR = 4.314, 95% CI 1.526–12.195), monthly income below 500 birr (AOR = 5.048, 95% CI 2.094–12.168), monthly income between 500 and 2000 birr (AOR = 2.593, 95% CI 1.032–6.517), distance greater than 24 kilometers from hospital to home (AOR = 10.091, 95% CI 3.509–29.020), more than four prescribed medications per visit (AOR=7.192, 95% CI= 2.171–23.824), never receiving counseling (AOR=22.334, 95% CI= 9.270–53.810), and diabetes-related admission (AOR=0.248, 95% CI= 0.078–0.789) were significantly associated with patients’ non-adherence to diabetes mellitus medications. Conclusion The level of diabetic medication adherence was suboptimal, and our study highlights that better monthly earning, nearby health-care accessibility, fewer prescribed medication, and getting appropriate counseling about diabetes mellitus were predictive of adherence to medications. Hence, an urgent intervention targeting the development of guidelines that involve these determinates should be employed to improve health care.

Prevalence of medication non-adherence and associated factors among diabetic patients in a tertiary hospital at Debre Markos, Northwest Ethiopia

“…In contrary to this, the proportion of non-adherence in our study was lower than findings of the studies conducted in Addis Ababa ( 4 ), Adigrat and Wukro General Hospitals ( 17 ), Kenya ( 20 ), Cameroon ( 19 ), India ( 32 ), Malaysia ( 33 ), Singapore ( 34 ), New York City ( 2 ), and USA ( 35 ). The impact of differences in sample size and adherence measurement tools on non-adherence levels should not be underestimated which could cause the differences observed among the results of the studies.…”

“…The level of non-adherence to medications among diabetes patients is variable in Ethiopia ranging from 34% ( 11 ) to 68.8% ( 12 ). Diabetic related complications ( 13 , 14 ), sex ( 13 ), age ( 15 ), level of education ( 13 , 16 ), lower income ( 15 ), cost of transport to the hospital ( 11 , 17 ), longer duration under treatment ( 15 , 18 , 19 ), history of admission ( 17 , 20 ), and taking alcohol ( 11 ) were reported to be predictors of medication non-adherence. Improving adherence to diabetes treatment thus is a vital public health issue.…”

Nondisclosure of Medical Related Information by Persons with Type 1 and Type 2 Diabetes Mellitus to Their Healthcare Providers: Do Different Patterns Exist?

“…Most often, adherence to antidiabetic medicines seems to be suboptimal, which may result in nondisclosure of information to the clinicians, leading to poor and suboptimal glycemic control. 12 Therefore, transparency of persons with DM with their healthcare providers is critical for the optimal management of diabetes and its complications. A good doctor–patient relationship may prevent nondisclosure of information among persons with DM.…”

“…For example, it was found that age, gender and living status are significant socio-demographic factors influencing the patients’ decision to disclose clinical information. 2 , 11 , 12 …”

Patients’ Adherence to Anti-diabetic Medications and Associated Factors in Mizan-Tepi University Teaching Hospital: A Cross-Sectional Study

“…These findings are in line with other studies findings. 26,27 Other factors that were significantly associated with adherence to anti-diabetes medicines were being retired from work and being housewife. The possible justification for this can be, their medication schedule will not overlap with working time and they spent majority of their time around their residency so that they might not forget taking their medications.…”