Adherence to Antidiabetic Medications Among Sudanese Individuals With Type 2 Diabetes Mellitus: A Cross-Sectional Survey

Abstract

Background: Adherence to antidiabetic medications is crucial for optimum glycemic control and decreasing complications. This study aimed to assess adherence to antidiabetic medications and the associated factors among individuals with type 2 diabetes attending Jabir Abu Eliz Diabetes Centre in Khartoum state, Sudan. Methods: This was a descriptive cross-sectional study, recruited 213 individuals with type 2 diabetes, and used a pretested questionnaire. Data were analyzed using the Statistical Package of Social Sciences version 21. Logistic regression analysis was used to check for factors that linked to poor adherence to diabetes medication. Results: The median duration of antidiabetic medications use was 8 years; 15.0% were highly adherent to diabetes medications, 44.6% were medium adherent, and 40.4% showed low adherence. Main factors and barriers were medication side effects (18.3%), use of herbal medicine (12.3%), and unavailability of medication (7%). Predictors to nonadherence were gender, and housing status (0.043 and 0.042, respectively). Conclusion: Level of adherence to diabetes medication was unsatisfactory as only 15% showed high adherence. Predictors of nonadherence were gender, and housing status. Effective interventions should be implemented to improve medication adherence, like appropriate patient education and involvement in the treatment plan.

Importance of medication adherence in treatment needed diabetic retinopathy

“…The results were compatible with the literature that young age and male sex tend to have lower medication adherence 16 . Those groups might tend to skip medication or return visits due to schedule conflict for work and family or subjective feelings of wellbeing.…”

Validation of the Arabic Version of General Medication Adherence Scale (GMAS) in Sudanese Patients with Diabetes Mellitus

“…22,32,33 Likewise, Sudanese patients with diabetes above 60 years old have consistently reported higher adherence to their diabetes medication than younger patients. 8,9 This could be because they have had diabetes for a longer period of time and may have started to experience more complications than their younger counterparts. Furthermore, the sample size in our study was larger than several recent studies conducted to measure adherence among patients with diabetes.…”

“…7 Poor adherence to anti-diabetic medications was reported among adults in many previous studies. [8][9][10] Lack of insurance coverage, unavailability of medicine, financial difficulties, brand-name medication substitution, and patients' negative perceptions that some medicines are not necessary are some factors that have led to patients' inability to buy their anti-diabetic medications. 9 Medication-related factors, such as side effects and the use of herbal medicine, were also reported as factors contributing to non-adherence.…”

“…9 Medication-related factors, such as side effects and the use of herbal medicine, were also reported as factors contributing to non-adherence. 8,9 Measurement of medication adherence can be direct or indirect. Examples of direct medication adherence method are directly observed therapy and measurement of drug concentration or its metabolite in the blood or urine.…”

“…Previous studies conducted to assess adherence among patients with DM in Sudan used questionnaires that were validated in western countries. 8 The Arabic version of General Medication Adherence Scale (GMAS) was validated in Saudi patients with chronic diseases, and it has been proposed to validate the tool in specific patient population such as diabetes. Moreover, Sudanese Arabic dialects are different from those of Saudi Arabia.…”