Arif Jemal, Jemal Abdela and Mekonnen Sisay
Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the characteristic of hyperglycemia. It is associated with abnormalities in carbohydrate, fat, and protein metabolism and results in chronic complications including microvascular, macrovascular, and neuropathic disorders. Evidence indicates that it is the level of blood glucose, which the patients can achieve during their treatment, influences diabetic complications on the long run. Achievement of optimal blood sugar level is generally based appropriate utilization of existing oral antidiabetic drugs, proper adherence to prescribed regimens and patients' own managements of their illness. The study was, therefore, aimed to assess adherence to oral antidiabetic drugs among diabetic patients attending chronic ambulatory wards of Hiwot Fana Specialized University Hospital (HFSUH).
Methods: Hospital based cross-sectional study design was conducted in HFSUH from January 1-February 28, 2015 G.C. Convenience sampling technique was employed to select eligible diabetic patients during the study period. The data was collected by interviewing T2DM patients receiving antidiabetic medication and attending chronic ambulatory wards of HFSUH using structured questionnaire that includes Morisky four item adherence assessment method. The most recent fasting blood glucose (FBG) level was used for glycemic control. The collected data was processed and analyzed with SPSS version 16. Cross tabulation followed by Chi-square (χ2) test was applied to show the association between categorical variables with adherence to antidiabetic medications.
Results: As per the Morisky's four item method of adherence, 40 (20.4%) patients reported that they were not being careful in taking their medication, 31 (15.8%) patients forgot to take medications regularly, only 3 (1.53%) patients stopped medication when they felt better and the other 5 (2.55%) patients reported that they stopped when they felt worse. From this finding, 138 (70.4%) patients adhered to the prescribed oral anti-diabetic medications. However, the remaining 58 (29.6%) T2DM patients replied positive response (yes) at least one of the four items and were classified as non-adherent to their medication. Educational status and residence showed a statistically significant association with adherence status (P<0.05). Moreover, a statistically significant association was also observed between adherences status and glycemic outcomes in the study (p<0.05).
Conclusion: the study showed that the level of adherence in T2DM patients was found to be suboptimal. The optimum blood glucose range might not be realized without proper adherence to the prescribed drug regimen. Therefore, patients should be advised on how to take their medication correctly and adequate information should be provided regarding the benefits of using them there by reducing both intentional and non-intentional non adherence.