Sriram Shanmugam

Merlin Mathews

Nimitha Treesa Baby

Praveen Raj

Reema Annie Ninan

Suresh Damodharan
Type 2 Diabetes Mellitus; Medication Adherence; Factors; Medication Non-Adherence; Morisky Medication Adherence Scale; Brief Medication Questionnaire; Knowledge, Attitude and Practice. ,

To evaluate the medication adherence in patients with Type 2 Diabetes Mellitus and factors influencing its non-adherence. A prospective observational study was carried out in the General Medicine and Diabetology department of a tertiary care teaching hospital in Coimbatore, India for a duration of 6 months (January 2018- June 2018). A total of 110 Type 2 diabetic patients who were on at least one anti-diabetic drug therapy were enrolled in the study. The patient data were collected in a structured patient profile form and assessed for non adherence using three different types of questionnaires; KAP, MMAS, BMQ. The results were analysed and subjected to statistical evaluation for its significance. During the study period a total of 110 patients were enrolled based on inclusion and exclusion criteria. Medication adherence was assessed using MMAS and adherence scores were calculated. The results revealed that 55.45% of the patients were low adherent and 35.54% were medium adherent. Only 10% of the patients were showing high adherence. Age was correlated with MMAS and a positive correlation was found, i.e. increase in age showed better adherence. Also subsequent increase in MMAS showed reduced HbA1c levels. KAP questionnaire was also used in the study and the results analysed reflected that the late adulthood scored a better KAP compared to others. The patients were evaluated to assess other factors responsible for their non-adherence towards medication using BMQ questionnaire. The results were compiled of behavioural barriers, recall barriers and access barriers. About 22.22% replied that all the factors screened were involved in their non-adherence and only 16.66% patients were adherent. The major factors responsible for non- adherence are forgetfulness (63.8%), difficult to pay (50%), Difficult getting refills (38.8%), Lack of knowledge (33.3%), Inconvenient dosage times (16.6%), too many drugs (5.5%) and side effects (2.77%). The majority of the population was found to be non-adherent to the medication. The major reasons for nonadherence were age, forgetfulness, duration of therapy, educational status, cost of medications, knowledge and complexity of medication regimen. Innovative methods are required to assist patients with lower adherence. Health professionals can a play major role in improving adherence by increasing the interaction with patients followed by adopting some measures like reducing the complexity of medication regimen, educational initiatives, reminder systems and reduced costs.

8 , 2 , 2018