[Factors associated with medication non-adherence in patients with type 2 diabetes mellitus: The first Algerian survey]

Factors Influencing Therapeutic Observance in Diabetic Subjects in the Province of Essaouira (Morocco): A Cross-Sectional Study

Background

Therapeutic observance remains a major problem in managing diabetic subjects, just like in other pathologies treated by medication and lifestyle modification. This study aims to determine the rate of therapeutic observance among diabetic subjects in the province of Essaouira and to identify the factors that influence it.

Methods

A cross-sectional questionnaire survey was conducted among 498 type 1 and 2 diabetic subjects, regularly being checked at different health centers in the province of Essaouira (Morocco).

Results

Almost a quarter of the surveyed subjects (23.3%) had poor observance. The results of the binary logistic regression model show that, in order of importance, observance is associated with six factors: Availability and access to medical treatment (Odds Ratio OR: 3; 95% CI confidence interval [1.78-5.03]); the side effects related to the treatment (OR: 2.60; 95% CI [1.65-4.09]); the family support (OR: 1.58 ; 95% CI [0.95-2.61]); duration of diabetes (OR: 0.55 ; 95% CI [0.34-0.88]); the age (OR: 0.50 ; 95% CI [0.30-0.82]); awareness level about the disease (OR: 0.43 ; 95% CI [0.21-0.90]).

Conclusion

The results of the present study have allowed us to identify several factors that can influence therapeutic observance, that prove necessary to be considered and acted upon.

Prevalence of poor medication adherence in type 2 diabetics in North Africa. Systematic review and meta-analysis

INTRODUCTION

Medication adherence is the cornerstone of the successful drug management of a chronic disease.

AIM

To develop a systematic review and meta-analysis of the prevalence and the factors associated with non-adherence in patients with type 2 diabetes in North African countries.

METHODS

A literature search was conducted on Medline via Pubmed with a complementary search on Google Scholar. The meta-analysis was conducted using the Metaprop function of R software. The Cochrane Q test and Higgins I² statistic were used to estimate the heterogeneity.

RESULTS

In total, 16 studies measuring the prevalence of medication adherence in North African countries were selected in this systematic review. The combined prevalence of non-adherence was 38% (95% CI 30%-47%) with a random-effects model. The meta-analysis revealed a significant heterogeneity between studies (I² = 96%, p <0.01). Factors associated with non-adherence in type 2 diabetics were education level, social security coverage, therapeutic education, cost of medication, socioeconomic level, the duration of diabetes, unbalanced diabetic diet, polypharmacy, female gender, family support and age.

CONCLUSION

The combined prevalence of non-adherence among type 2 diabetics in North Africa was high and multifactorial, requiring global and integrated management by patients, physicians and pharmacists.

Exploring variables associated with medication non-adherence in patients with type 2 diabetes mellitus

OBJECTIVE

This study aims to assess medication adherence and explore its predictors in outpatients with type 2 diabetes.

METHOD

This cross-sectional study collected socio-demographics, disease-related information, and different biomedical variables for type 2 diabetes patients attending a Jordanian Diabetes center. The four-item medication adherence scale (4-IMAS) and the beliefs about medications questionnaire (BMQ) which includes necessity and concerns were used. Stepwise backward quartile regression models were conducted to evaluate variables associated with the Necessity and Concerns scores. Stepwise ordinal regression was conducted to evaluate variables associated with adherence.

RESULTS

287 diabetic patients participated in the study. Almost half of the participants (46.5%) reported moderate adherence and 12.2% reported low adherence. Significant predictors of the adherence were necessity score (OR = 14.86, p <0.01), concern score (OR = 0.36, p <0.05), and frequency of medication administration (OR = 0.88, p- <0.01). Education was a significant predictor of Necessity and Concerns scores (β = 0.48, -0.2, respectively).

CONCLUSION

Simplifying the medication regimen, emphasizing medication necessity and overcoming medication concerns should be targeted in future diabetes intervention programs to improve medication adherence and hence glycemic control among diabetic patients.

Factors Influencing Medication Non-Adherence among Chinese Older Adults with Diabetes Mellitus

Objectives: This study aimed to examine the prevalence of medication non-adherence among older adults with diabetes mellitus (DM) in Shandong province, China and to identify its influencing factors. Methods: A sample of 1002 older adults aged 60 or above with DM was analyzed. Medication adherence was measured using the Morisky–Green–Levine (MGL) Medication Adherence Scale. Descriptive statistical analysis, chi-square test, univariate and multivariate logistic regression analyses were employed. Results: The prevalence of self-reported medication non-adherence among older adults with DM was 19.9%. Female respondents (adjusted odds ratio (AOR) = 1.56, 95% CI: 1.09–2.24) and respondents who perceived medication adherence to be unimportant (AOR = 1.69, 95% CI: 1.05–2.74) were more likely to experience medication non-adherence. Respondents with 5 years of disease duration or longer were less likely (AOR = 0.63, 95% CI: 0.46–0.87) to experience medication non-adherence. Conclusions: This study showed that about one out of five older adults with DM in Shandong province, China, experienced medication non-adherence, and that gender, disease duration and perceived importance of medication adherence were associated with medication non-adherence in this population group. Provision of counseling and health education programs could be the future priority to raise patients’ awareness of the importance of medication adherence and improve patients’ self-management of DM.