Multifactorial approach and adherence to prescribed oral medications in patients with type 2 diabetes*

Abstract

The aims of this study were to assess adherence to oral hypoglycaemic/cardiovascular drugs and determine non-adherence predictors in type 2 diabetes patients. It was designed as a population-based cross-sectional study in which 90 patients from a primary care setting were studied. Pill count and self-report methods were used to measure adherence. Logistic regression analysis was performed to predict factors related to non-adherence. Adequate adherence to all drugs was found in 29 patients (35.4%; 95% confidence interval (CI) 25.0-45.7). Variables associated with non-adherence were HbA1c odds ratio (OR) 2.32 (95% CI: 1.09-4.95), systolic blood pressure OR 1.68 (95% CI: 1.08-2.62), total cholesterol OR 1.34 (95% CI: 1.08-1.66), number of pills OR 1.80 (95% CI: 1.26-2.55) and duration of disease OR 0.44 (CI 95%: 0.24-0.83). In conclusion, one in three patients had adequate adherence. Factors associated with non-adherence were duration of disease, complexity of drug regimen and inadequate control of cardiovascular risk factors.

Medication Adherence and Direct Treatment Cost among Diabetes Patients Attending a Tertiary Healthcare Facility in Ogbomosho, Nigeria

“…A Nigerian study using another tool, the Adherence and SelfManagement Monitoring Tool (ASMMT), found 59% of its sample diabetes patients to be non-adherent 23 . Ahmad et al in a study among Malaysian diabetic patients found 53% to be non-adherent using the Medication Compliance Questionnaire, while a study using pill count and other selfreporting methods found adherence to be adequate in only 29% of patients 20,45 . The predictors of medication nonadherence shown in previous studies include disease and medication beliefs, poverty, service dissatisfaction, and using traditional medicines 19,31,40,46,47 .…”

Review: Improving compliance with Helicobacter pylori eradication therapy: when and how?

“…Complexity of treatment has been proven to be a factor in reducing compliance with medications in other clinical areas such as the management of type 2 diabetes [Mateo et al 2006]. The same is true in H. pylori eradication where the number of medications which need to be consumed daily in is daunting.…”

More medications, fewer pills: Combination medications for the treatment of hypertension

“…It is well recognized that medication adherence is a significant impediment to BP control in hypertensive patients. Regimens with fewer pills or once-daily dosing are more likely to be associated with enhanced adherence than more complicated regimens (17)(18)(19). Thus, one strategy that may be effective in promoting adherence is reducing the number of pills by using fixed-dose combination therapies.…”