Medication Adherence in Type 2 Diabetes: The ENTRED Study 2007, a French Population-Based Study

Abstract

BackgroundAdherence to prescribed medications is a key dimension of healthcare quality. The aim of this large population-based study was to evaluate self-reported medication adherence and to identify factors linked with poor adherence in patients with type 2 diabetes in France.MethodologyThe ENTRED study 2007, a French national survey of people treated for diabetes, was based on a representative sample of patients who claimed reimbursement for oral hypoglycaemic agents and/or insulin at least three times between August 2006 and July 2007, and who were randomly selected from the database of the two main National Health Insurance Systems. Medication adherence was determined using a six-item self-administered questionnaire. A multinomial polychotomous logistic regression model was used to identify factors associated with medication adherence in the 3,637 persons with type 2 diabetes.Principal FindingsThirty nine percent of patients reported good medication adherence, 49% medium adherence and 12% poor adherence. The factors significantly associated with poor adherence in multivariate analysis were socio-demographic factors: age <45 years, non-European geographical origin, financial difficulties and being professionally active; disease and therapy-related factors: HbA1c>8% and existing diabetes complications; and health care-related factors: difficulties for taking medication alone, decision making by the patient only, poor acceptability of medical recommendations, lack of family or social support, need for information on treatment, reporting no confidence in the future, need for medical support and follow-up by a specialist physician.ConclusionsIn a country with a high level of access to healthcare, our study demonstrated a substantial low level of medication adherence in type 2 diabetic patients. Better identification of those with poor adherence and individualised suitable recommendations remain essential for better healthcare management.

Drug Compliance among Type 2 Diabetic patients in Jazan Region, Saudi Arabia.

“…Patients with poor adherence showed low glycaemic control ( HbA1c >8 ) and this is similar to the results found in other researches [4].…”

“…This study explored therapeutic adherence and the factors contributing to the adherence of diabetic patients in Jazan region. Non adherence with medication in this study was similar to the earlier finding in Egypt [7], Palestine [10], France [4], Poland [14] and Saudi Arabia [11] In Palestine study, non-compliance was divided into two categories ( 51.4 % poor compliance and 6.5 % noncompliance ) [10]. In France the non-compliance was divided into two categories also (49% medium adherence and 12% poor adherence ) [4].…”

“…Results showed no significant association between poor-adherence and type of treatment or number of dosages. This results similar to that's conducted in French [4], in contrast to the Saudi study that's found non-adherence was least with the single drug regimen while it was highest among patients who were on combined oral and insulin treatment [11].…”

“…According to the World Health Organization (WHO), adherence is the extent to which a person's behavior -taking medication, following a diet, and/or executing lifestyle changes -corresponds with agreed recommendations from the health care provider .However, medication non-adherence is particularly common among patients with type 2 diabetes and inadequate adherence compromises safety and treatment effectiveness, leading to increased mortality and morbidity with considerable direct and indirect costs to the healthcare system. A recent WHO report states that, because the magnitude of non-adherence and the scope of its sequelae are so alarming, more health benefits worldwide would result from improving adherence to existing treatments than by developing new medical treatments [4] Clinical experience confirms, however, that despite the availability of increasingly modern and effective methods of treatment at least half of the patients fail to achieve satisfactory therapy goals and that non-compliance is believed to be the most common cause of treatment failures. After several decades of research, it was concluded that medication non-adherence is due to many factors including lack of adequate knowledge about medication and treatment goals, beliefs about the medication, complex regimens that are difficult to manage, side effects, and costs associated with medications [5] [6].…”

Assessment of Medication Adherence in Type II Diabetic Patients: A Cross-sectional Study

“…15,16 Worldwide, studies on medication adherence among diabetic patients have shown a wide variation. [17][18][19][20][21][22][23][24] In India, [25][26][27] Limited studies from Southern and Northern regions of India have documented wide variation in the medication adherence and have addressed the issues of nonadherence in diabetic patients. 21,[28][29][30][31][32][33] AIM Therefore, this study was conducted to assess the medication adherence among type II diabetic patients attending a tertiary care hospital in Navi Mumbai, India.…”