Diabetes Mellitus; Correlation of Treatment Satisfaction Parameters, Educational Status and Therapy Type With Adherence in Type-Ii Diabetes Mellitus

Abstract

ABSTRACT… Objectives: Diabetes Mellitus being a major issue faced by developing countries like Pakistan. Non-adherence is a major issue in achieving a desired therapeutic goal. This study aims at determining relation with the drug non-adherence associated with the treatment regime, treatment satisfaction and educational status of the person. Study Design: This was a cross sectional study. Place and Duration: This study was done at the Diabetes clinic, Nishtar hospital, Multan. Total 242 diabetic patients were studied over a period of 10 months. Methodology: The inclusion criteria was set as patients who have been diagnosed with Diabetes Type II and had been on oral hypoglycemic medications for about last 5 months or more. Those patients who were diagnosed with Type I diabetes and Type II diabetes less than 5 months were not included in the study. Also those patients who were on Insulin therapy were also excluded. Socio-demographic data was obtained along with therapy type and educational status. Drug adherence level was studied with the 8-item Morisky (MMAS-8). Treatment satisfaction was studied with the help of treatment satisfaction questionnaire for medication. The data was analyzed on the SPSS version 23 with significant p-value <0.05. Results: Among 242 patients 152(62.81%) were females and 90(37.19%) were males. Mean age of the patients were 47.68±15.13 years. Patients on combination therapy were (n=134, 55.3%) and on monotherapy were (n=108, 44.6%). Mean adherence score was 5.4±1.1.The mean for four domains of Treatment Satisfaction Questionnaire for Medication(TSQM) were: effectiveness= 66.93±15.27, side effects=32.09±26.91, convenience =62.59±14.49 and satisfaction= 65.49±16.13.Non-adherence was found to be associated with age, illiteracy, side-effects, satisfaction and convenience (p<0.05). Conclusion: Non-adherence must be overcome in patients to achieve appropriate glucose levels. Significant factors affecting the adherence levels were Illiteracy, Side effects, convenience and satisfaction of the patient. Public awareness campaigns and regular clinic visits should be encouraged. Drugs having lower sideeffects, higher satisfaction levels and combined generics for once daily dosing having greater convenience should be used.