Medication adherence assessment among patients with type 2 diabetes mellitus treated polytherapy in indonesian community health center: A cross sectional-study

Abstract

A BSTRACT Background: Type 2 diabetes mellitus (T2DM) is a chronic disease where most of the patients usually need polytherapy. This could affect their medication adherence (MA). However, other complex factors may also associate with MA, which are important to identify. Aim: The purpose of this study was to evaluate the MA of patients with T2DM who received polytherapy and to identify other factors that can affect the MA. Materials and Methods: This was a cross-sectional study conducted in seven community health centers in Jakarta with HbA 1C representing their MA level. Poor controlled blood glucose with Hemoglobin A 1C (HbA 1C ) of ≥7% is indicated to have low MA. All characteristics were collected to identify factors that are potentially associated with low MA. The univariate analysis tests were used to analyze factors that potentially associate with low MA. Multiple logistic regression analysis was performed in the factors to find their relationship with low MA. Results: The study obtained 143 patients with a female dominance (67.8%) and mean ± standard deviation (SD) age of 59.53 ± 9.251 years. Approximately 75.5% of the patients had low MA (HbA 1C ≥ 7). Univariate analysis found that duration of T2DM significantly ( P = 0.047) related to MA, where patients with T2DM of less than or equal to 5 years tended to have low MA. Logistic regression showed that patients with T2DM less than or equal to 5 years ( P = 0.015, odds ratio = 1.206, 95% confidence interval = 1.216–8.014) were associated with low MA. Conclusion: Patients with the duration of T2DM less than or equal to 5 years surprisingly were susceptible to have low MA. Low MA was not affected by polytherapy.

Exploring of Determinants Factors of Anti-Diabetic Medication Adherence in Several Regions of Asia – A Systematic Review

“… 47 , 57 This review found no negative association in education level subdomain and knowledge subdomain; however, twelve studies from seven countries concluded that education level, knowledge about diabetes, and knowledge about medications did not affect medication adherence. 32 , 37–41 , 43–45 , 47 , 50 , 58 One of the interesting findings in the patient-related domain was the negative association of occupational factors in one Indian study. 33 In contrast, ten other studies stated that this factor was not associated with medication adherence.…”

“… 33 In contrast, ten other studies stated that this factor was not associated with medication adherence. 37 , 39–41 , 43–45 , 47 , 50 , 58 Detailed information about patient-related factors is summarized in Figure 3 .

Figure 3 Conceptual framework model of medication adherence of diabetes patients in several Asian regions.

…”

“…One specific factor includes positive and negative associations with medication adherence in diabetes patients (diabetes durations). 39 , 40 , 58 Research in China 39 , 40 stated a linear association between the duration of diabetes and adherence to medication; however, research in Indonesia found the opposite. 39 , 40 , 58 Meanwhile, ten other studies did not find an association between the duration of diabetes and adherence to medication.…”

“… 39 , 40 , 58 Research in China 39 , 40 stated a linear association between the duration of diabetes and adherence to medication; however, research in Indonesia found the opposite. 39 , 40 , 58 Meanwhile, ten other studies did not find an association between the duration of diabetes and adherence to medication. 32 , 34 , 37 , 38 , 40–43 , 47 , 50 …”

“… (Wulandari et al, 2020)/Indonesia/community health centre/Cross-sectional/T2DM. 58 143 HbA1c level ● HbA1c ≥ 7 (Low adherence) ● HbA1c < 7 (Adherence) ● Low adherence (75.5%) ● Adherence (24.5%) ● Disease duration ● Age ● Gender ● Level of education ● Occupation ● Other chronic diseases ● Number of medicine ● Number of regular daily drugs 77 20. (Xu et al, 2020)/China/Elderly clinic/Cross-sectional/T1DM and T2DM.…”