Non Adherence and Contributing Factors among Ambulatory Patients with Anti Diabetic Medications in Adama Referral Hospital

Gelaw BK, Mohammed A, Tegegne GT, Defersha AD, Fromsa M, Tadesse E, Thrumurgan G and Ahmed M

Background: The term diabetes mellitus describes metabolic disorders of multiple etiologies characterized by hyperglycemia with disturbances of carbohydrates, fat and protein metabolism resulting from defects in insulin secretion, insulin action or both. Anti-diabetic medications are integral for glycemic control in diabetes. Non adherence to drugs can alter blood glucose levels, resulting in complications. The objective of this study was to determine the magnitude of non-adherence and its contributing factors among diabetic patients attending the diabetic clinic in Adama hospital.

Methods: This descriptive cross-sectional study was carried out among patients with diabetes mellitus attending the diabetes mellitus clinic of Adama referral hospital. Every other patient was selected and data regarding their medication adherence was collected using a structured interview. Data analysis was carried out using SPSS-16.

Result: The response rate from this study was 98.3%. A total of 270 patients were interviewed; 51.5% were males. A total of 68.1% of the patients included in the study were married. 14% were younger than 40 years of age,50% were between 40 and 60 years of age. 21.8% of the participants ascribed their non-adherence to forgetting to take their medications. Patients with duration of diabetes ≤ 5 years (82.07%) were more compliant to their medication than those with >5 years 60.8%, which was found to be statistically significant (P=0.003). Insulin 47% and glibenclamide plus metformine 43.7% were the most commonly prescribed mono and combination therapies respectively. Common co morbid conditions include, Hypertension 148(54.82%), Visual impairment 89(32.96%). The proportion of male patients adherent to their anti-diabetic medications was found to be lower 69.78% compared to the female patients (74.81%), but the difference was not statistically significant (p>0.05).

Conclusion: Most diabetic patients are currently being managed with the most effective available drugs. However as the result from this study indicates the desired blood sugar level could not be controlled and maintained adequately. This was because of poor adherence with the prescribed drug regimen and poor knowledge and practice of successful self management.