Prevalence of Medication Non-Adherence and Associated Factors among Diabetic Patients in A Tertiary Hospital at Debre Markos, Northwest Ethiopia

Non-adherence to Anti-diabetic Prescriptions Among Type 2 Diabetes Mellitus Patients in the Kurdistan Region of Iraq

BACKGROUND

Treatment adherence is a primary key in controlling diabetes disease. The study aims to determine the prevalence of treatment adherence in type 2 diabetes mellitus (T2DM) patients, investigate the potential influence of adherence on elevated blood glucose levels, and identify the key factors which play a role in non-adherence to the prescribed drugs.

METHOD

A cross-sectional study method was utilized to collect data from all T2DM patients at the Diabetic and Endocrine Centre and Shar Hospital in Sulaymaniyah city in the Kurdistan region of Iraq from February 2022 to April 2022. The data collection was performed through a structured questionnaire. The prevalence of drug adherence was assessed using the Morisky Medication-Taking Adherence Scale (4-item), and the glycated hemoglobin test (A1C) was used to determine the blood glucose level.

RESULT

A total of 300 participants were studied, and more than half of them (192; 64%) revealed that they did not adhere to their anti-diabetic medications. Non-adherence was significantly associated with higher A1C. Several barriers to non-adherence were identified as multiple medications, feeling the dose given is high, lack of finance, and side effects by 209 (70%), 116 (39%), 113 (38%), and 103 (34%), respectively.

CONCLUSION

The current study's result revealed that most T2DM patients have no adherence to their medication. This non-adherence is significantly linked to higher A1C levels, emphasizing the critical role of medication compliance in managing diabetes effectively. The study also sheds light on the multiple barriers such as taking multiple prescriptions, the perception that the dose is excessive, lack of finances, and experiencing side effects, which contribute to non-adherence among diabetes patients. These findings underscore the need for healthcare providers to address these barriers and develop tailored strategies to enhance medication adherence among individuals with diabetes.

Co-occurrence of Modifiable Risk Factors for Cardiovascular Disease amongst Diabetic Patients in Lagos State, Nigeria

BACKGROUND

Diabetes significantly increases the likelihood of developing cardiovascular disease (CVD). This risk can be reduced by addressing modifiable risk factors. The objectives of this study were to assess the modifiable risks for CVD amongst persons with diabetes and identify the factors associated with multiple risk factors.

METHODS

This cross-sectional study was conducted amongst 357 diabetic patients attending a large tertiary hospital in Southwest Nigeria. Eligible patients were recruited consecutively on clinic days till the minimum sample size was reached. An interviewer-administered survey tool adapted from the World Health Organization STEPS was used to obtain information from study participants. The following risk factors were assessed: tobacco use, obesity, high blood pressure, physical activity, sedentary time and hours of sleep. Data were analysed using the STATA version 15.0 (Stata Corp.) statistical programme.

RESULTS

The mean age of the participants was 61.7 ± 12.6 years, and they were mostly females (63.9%). Of the risk factors assessed, the most prevalent modifiable risk factors amongst the respondents were inadequate sleep - <8 h on average (91.6%), abdominal obesity (82.6%) and high blood pressure (72%). Others were inadequate physical activity (56%) and lifetime tobacco use (21%). Up to 40.3% of the diabetic persons had three or more co-existing CVD risk factors. Age, gender, work and marital status (P ≤ 0.01) were statistically associated with multiple CVD risk factors. Being male, unmarried and increasing age were predictors of multiple CVD risk factors amongst the diabetic patients.

CONCLUSION

A significant proportion of the diabetic patients have multiple co-existing modifiable CVD risks. Abdominal obesity and poor sleep were the most prevalent. Older men who are unmarried were more likely to have multiple risks. Primary and secondary preventive measures to address CVD risks amongst diabetic patients are warranted and should target older unmarried men.

Effects of Educational Interventions on Dietary Adherence among Type 2 Diabetics in Zahedan: Using the Health Action Process Approach

Background

Type 2 diabetes is the most common type of diabetes, and dietary adherence is a self-care practice. This research aims to improve dietary adherence among type 2 diabetics in Zahedan using the HAPA model.

Methods

In this cross-sectional study, a total of 210 type 2 diabetics admitted to hospital clinics in Zahedan during summer 2022 were selected. The intervention group (n = 105) and the control group (n = 105) were from hospitals in Zahedan. Samples were selected by the simple random sampling method among the diabetics. After data collection using the demographic characteristics questionnaire and the Dietary Adherence Questionnaire and the HAPA model constructs questionnaire, the pre-test analysis was performed. One and three months after the educational intervention, the questionnaires on HAPA model constructs and self-care behavior were filled out by the patients. Next, data were analyzed using independent t-test, chi-square test, and the Shapiro-Wilk test in SPSS 23.

Results

The results showed that all of the HAPA model constructs had significant differences, one and three months after the educational intervention (P = 0.001), indicating the effectiveness of education in the intervention group. However, there was no significant difference in the control group (P = 0.009).

Conclusion

After the intervention using the HAPA model, the model's constructs had a significant impact on the patients' self-care of dietary adherence following the training.