Medication Adherence and Its Associated Factors among Type-2 Diabetes Mellitus Patients

Authors

Abstract

Introduction: Diabetes is a chronic metabolic disorder of carbohydrates, fats and proteins characterized by hyperglycemia, where a beta cells of pancreas either donot secrete enough insulin or resist to the produce insulin.

Objective: To determine the factors influencing adherence to anti-diabetic medication among type-2 diabetes patients.

Method: The study was descriptive cross- sectional and 196 type-2 diabetes patients were enrolled by purposive sampling technique. Adherence level was screened with the Morisky Green Levine 4 item (MGL-4 item)

Results: A total of 196 respondents (mean age55.34±12.98). Analysis of MGL-4 item scores of patients showed that 38.3% had poor adherence level, 61.7% had moderate adherence level and none of the respondents were found to have high level of adherence with prescribed anti-diabetic medications. The variables like age, gender, marital status, educational, occupation, comorbid conditions, forgetfulness, pill burden, busy schedule, high cost, different brands, were not found significantly associated with medication adherence (P>0.05) however, majority of the patients were found to have forgetfulness (15.8%) followed by forgetfulness plus busy schedule (13.3%). However, age was found significantly associated with glycemic control (HbA1c level). 

Conclusion: A low to moderate adherence level was observed in the study which needs to be recognized and improved through general adherence advocacy.

Keywords: Anti-diabetic drugs, Diabetes Mellitus, Glycemic control, Medication adherence

Keywords:

Anti-diabetic drugs, Diabetes Mellitus, Glycemic control, Medication adherence

DOI

https://doi.org/10.22270/jddt.v16i3.7628

Author Biographies

Jyoti Mangrati , Department of Pharmacy, HOPE International College, Kathmandu Nepal

Department of Pharmacy, HOPE International College, Kathmandu Nepal

Hemank KC , Department of Pharmacy, Valley College of Technical Sciences, Kathmandu Nepal

Department of Pharmacy, Valley College of Technical Sciences, Kathmandu Nepal

References

1. Xu N, Xie S, Chen Y, Li J, Sun L. Factors influencing medication non-adherence among Chinese older adults with diabetes mellitus. International Journal of Environmental Research and Public Health. 2020;17(17):6012. https://doi.org/10.3390/ijerph17176012 PMid:32824886 PMCid:PMC7503473

2. Upadhyay DK, Palaian S, Ravi Shankar P, Mishra P, Sah AK. Prescribing pattern in diabetic outpatients in a tertiary care teaching hospital in Nepal. J Clin Diagn Res. 2007;1(4):248-55.

3. Gupta S, Jain U, Chauhan N. Laboratory diagnosis of HbA1c: a review. J Nanomed Res. 2017;5(4):00120. https://doi.org/10.15406/jnmr.2017.05.00120

4. Kumar N, Unnikrishnan B, Thapar R, Mithra P, Kulkarni V, Holla R, et al. Distress and its effect on adherence to antidiabetic medications among Type 2 diabetes patients in coastal South India. J Nat Sci Biol Med. 2017;8(2):216-20. https://doi.org/10.4103/0976-9668.210008 PMid:28781491 PMCid:PMC5523532

5. Chaudhari VP, Ganguly B. Changing pattern of prescribing antidiabetic agents in patients suffering from diabetes mellitus. 2013. https://doi.org/10.5455/2319-2003.ijbcp20130109

6. Pokhrel S, Shrestha S, Timilsina A, Sapkota M, Bhatt MP, Pardhe BD. Self-Care adherence and barriers to good glycaemic control in Nepalese type 2 diabetes mellitus patients: a hospital-based cross-sectional study. Journal of multidisciplinary healthcare. 2019;12:817. https://doi.org/10.2147/JMDH.S216842 PMid:31632050 PMCid:PMC6791337

7. Sapkota S, Jo-anne EB, Aslani P. Nepalese patients' perceptions of treatment modalities for type 2 diabetes. Patient preference and adherence. 2016;10:1777. https://doi.org/10.2147/PPA.S113467 PMid:27695296 PMCid:PMC5028164

8. Bagonza J, Rutebemberwa E, Bazeyo W. Adherence to anti diabetic medication among patients with diabetes in eastern Uganda; a cross sectional study. BMC health services research. 2015;15(1):1-7. https://doi.org/10.1186/s12913-015-0820-5 PMid:25898973 PMCid:PMC4405852

9. Aminde LN, Tindong M, Ngwasiri CA, Aminde JA, Njim T, Fondong AA, et al. Adherence to antidiabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC endocrine disorders. 2019;19(1):1-9. https://doi.org/10.1186/s12902-019-0360-9 PMid:30943969 PMCid:PMC6446302

10. Thapar R, Holla R, Kumar N, Aithal S, Karkera S, Rao C, et al. Factors influencing adherence to anti-diabetes medications among type 2 diabetes patients attending tertiary care hospitals in Mangaluru. Clinical Epidemiology and Global Health. 2020;8(4):1089-93. https://doi.org/10.1016/j.cegh.2020.03.025

11.Shrestha DB, Budhathoki P, Sedhai YR, Marahatta A, Lamichhane S, Nepal S, et al. Type 2 Diabetes Mellitus in Nepal from 2000 to 2020: A systematic review and meta-analysis. F1000Research. 2021;10. https://doi.org/10.12688/f1000research.53970.1 PMid:34621512 PMCid:PMC8459622

12 Kassahun A, Fanta Gashe EM, Rike WA. Nonadherence and factors affecting adherence of diabetic patients to anti-diabetic medication in Assela General Hospital, Oromia Region, Ethiopia. Journal of pharmacy & bioallied sciences. 2016;8(2):124. https://doi.org/10.4103/0975-7406.171696 PMid:27134464 PMCid:PMC4832902

13 Polonsky W, Henry R. Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors. Patient Prefer Adherence. 2016; 10: 1299-307. https://doi.org/10.2147/PPA.S106821 PMid:27524885 PMCid:PMC4966497

14 Olokoba A, Obateru O, Olokoba L. Type 2 diabetes mellitus: a review of current trends, Oman Med. J. 27 (2012) 269-273. 2012. https://doi.org/10.5001/omj.2012.68 PMid:23071876 PMCid:PMC3464757

15 Kumar N, Unnikrishnan B, Thapar R, Mithra P, Kulkarni V, Holla R, et al. Distress and its effect on adherence to antidiabetic medications among Type 2 diabetes patients in coastal South India. J Nat Sci Biol Med. 2017;8(2):216-20. https://doi.org/10.4103/0976-9668.210008 PMid:28781491 PMCid:PMC5523532

16 Grnaz AE. Students' Forgetfulness as a Learning Problem Some Reasons and Solutions. Middle East J Sci Publ. 2020;3(2):100-81.

17 Blüher M, Kurz I, Dannenmaier S, Dworak M. Pill burden in patients with type 2 diabetes in Germany: Subanalysis from the prospective, noninterventional PROVIL study. Clin Diabetes. 2015;33(2):55-61. https://doi.org/10.2337/diaclin.33.2.55 PMid:25897184 PMCid:PMC4398007

18 Hasan SS, Lu CY, Babar ZUD. Access to High Cost Medicines: An Overview. Equitable Access to High-Cost Pharm. 2018;(March):1-10. https://doi.org/10.1016/B978-0-12-811945-7.00001-4

19 Gulbech Ording A, Toft Sørensen H. Concepts of comorbidities, multiple morbidities, complications, and their clinical epidemiologic analogs. Clin Epidemiol. 2013;5(1):199-203. https://doi.org/10.2147/CLEP.S45305 PMid:23861599 PMCid:PMC3704301

20 Voor In 'T Holt AF. Age: A variable whose definition we should not ignore. Infect Control Hosp Epidemiol. 2019;40(12):1444-5. https://doi.org/10.1017/ice.2019.271 PMid:31589135

21 De Benedetto M. Gender and Language. Eur J Law Reform. 2020;22(1):49-60. https://doi.org/10.5553/EJLR/138723702020022001004

22 Wu C yi, Lin K chung. Defining occupation: A comparative analysis. J Occup Sci. 1999;6(1):5-12. https://doi.org/10.1080/14427591.1999.9686446

23. Khdour MR, Awadallah HB, Al-Hamed DH. Treatment Satisfaction and Quality of Life among Type 2 Diabetes Patients: A Cross-Sectional Study in West Bank, Palestine. J Diabetes Res. 2020;2020(8). https://doi.org/10.1155/2020/1834534 PMid:32908934 PMCid:PMC7471818

24. Badi S, Abdalla A, Altayeb L, Noma M, Ahmed MH. Adherence to Antidiabetic Medications Among Sudanese Individuals With Type 2 Diabetes Mellitus: A Cross-Sectional Survey. J Patient Exp. 2020;7(2):163-8. https://doi.org/10.1177/2374373519831073 PMid:32851136 PMCid:PMC7427351

25. Balkhi B, Alwhaibi M, Alqahtani N, Alhawassi T, Alshammari TM, Mahmoud M, et al. Oral antidiabetic medication adherence and glycaemic control among patients with type 2 diabetes mellitus: A cross-sectional retrospective study in a tertiary hospital in Saudi Arabia. BMJ Open. 2019;9(7):1-11. https://doi.org/10.1136/bmjopen-2019-029280 PMid:31340969 PMCid:PMC6661664

26. Ayele BA, Tiruneh SA, Ayele AA, Engidaw MT, Yitbarek GY, Gebremariam AD. Medication adherence and its associated factors among type 2 diabetic patients in Ethiopian General Hospital, 2019: Institutional based cross-sectional study. PLOS Glob Public Heal. 2022;2(5):e0000099. https://doi.org/10.1371/journal.pgph.0000099 PMid:36962151

27. Abebaw M, Messele A, Hailu M, Zewdu F. Adherence and Associated Factors towards Antidiabetic Medication among Type II Diabetic Patients on Follow-Up at University of Gondar Hospital, Northwest Ethiopia. Adv Nurs. 2016;2016:1-7. https://doi.org/10.1155/2016/8579157

28. Elsous A, Radwan M, Al-Sharif H, Mustafa AA. Medications adherence and associated factors among patients with type 2 diabetes mellitus in the Gaza Strip, Palestine. Front Endocrinol (Lausanne). 2017;8(JUN):1-9. https://doi.org/10.3389/fendo.2017.00100 PMid:28649231 PMCid:PMC5465265

29. Mirghani HO. An evaluation of adherence to anti-diabetic medications among type 2 diabetic patients in a sudanese outpatient clinic. Pan Afr Med J. 2019;34:1-9. https://doi.org/10.11604/pamj.2019.34.34.15161 PMid:31762902 PMCid:PMC6859029

30. Khdour MR, Awadallah HB, Al-Hamed DH. Treatment Satisfaction and Quality of Life among Type 2 Diabetes Patients: A Cross-Sectional Study in West Bank, Palestine. J Diabetes Res. 2020;2020(8). https://doi.org/10.1155/2020/1834534 PMid:32908934 PMCid:PMC7471818

31. Mannan A, Hasan MM, Akter F, Rana MM, Chowdhury NA, Rawal LB, et al. Factors associated with low adherence to medication among patients with type 2 diabetes at different healthcare facilities in southern Bangladesh. Glob Health Action. 2021;14(1). Available from: https://doi.org/10.1080/16549716.2021.1872895

Published

2026-03-15
Statistics
Abstract Display: 126
PDF Downloads: 127
PDF Downloads: 14

How to Cite

1.
Mangrati J, Hemank KC. Medication Adherence and Its Associated Factors among Type-2 Diabetes Mellitus Patients. J. Drug Delivery Ther. [Internet]. 2026 Mar. 15 [cited 2026 Apr. 18];16(3):47-5. Available from: https://www.jddtonline.info/index.php/jddt/article/view/7628

How to Cite

1.
Mangrati J, Hemank KC. Medication Adherence and Its Associated Factors among Type-2 Diabetes Mellitus Patients. J. Drug Delivery Ther. [Internet]. 2026 Mar. 15 [cited 2026 Apr. 18];16(3):47-5. Available from: https://www.jddtonline.info/index.php/jddt/article/view/7628