Medication adherence and influencing factors in patients with type 2 diabetes attending a tertiary hospital in South-West Nigeria

Adherence to antidiabetic medications (ADMs) remains a serious challenge among type 2 diabetes mellitus (T2DM) patients. Factors affecting medication adherence are not fully understood in Nigeria. This qualitative study explored patients’ views on barriers and facilitators of medication adherence. Data collection was through face-to-face, semistructured, in-depth interviews conducted on 25 purposively sampled patients attending a public tertiary hospital. The interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis based on socioecological framework. NVIVO version 10 identified more codes. Most commonly identified barriers were organizational (clinic structure), personal (perception of T2DM as a dangerous illness), interpersonal (lack of spousal support), and community (concerns about taking ADMs in social gatherings). It was observed that female patients received more spousal support than the males. The facilitators of adherence include perceiving medication-taking a routine, the need to live longer, having savings for ADMs, purchasing medications to last until the next clinic visit. This study identified barriers and facilitators unique to Nigerian T2DM patients. Interventions anchored on these factors would improve medication adherence.

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Factors associated with low medication adherence in patients with Type 2 diabetes mellitus attending a tertiary hospital in Bangladesh

Lifestyle Medicine ◽

10.1002/lim2.47 ◽

2021 ◽

Author(s):

Sheikh Mohammed Shariful Islam ◽

Md. Tauhidul Islam ◽

Riaz Uddin ◽

Tania Tansi ◽

Shamim Talukder ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Medication Adherence ◽

Tertiary Hospital ◽

Factors Associated

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Relationships between personality, emotional distress and self-rated medication adherence in ethnically diverse adults with type-2-diabetes mellitus

PsycEXTRA Dataset ◽

10.1037/e546872013-280 ◽

2013 ◽

Author(s):

Seth A. Margolis ◽

Jeffrey S. Gonzalez

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Medication Adherence ◽

Emotional Distress ◽

Ethnically Diverse

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Ten years type 2 diabetes risks among doctors in Ondo State, South West Nigeria

Endocrine Abstracts ◽

10.1530/endoabs.65.p255 ◽

2019 ◽

Author(s):

Adenike Enikuomehin ◽

Oludamola Adejumo ◽

John Ajiboye ◽

Oladimeji Junaid ◽

Fakhraddeen Muhammad ◽

...

Keyword(s):

Type 2 Diabetes ◽

South West ◽

Ondo State

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815-P: Medication Adherence by Pill Count Using Medical Reconciliation in Patients with Type 2 Diabetes

Diabetes ◽

10.2337/db20-815-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 815-P

Author(s):

MEGUMI SHIOMI ◽

YOICHI TANAKA ◽

MOMOKA KUROBUCHI ◽

TESSHU TAKADA ◽

KATSUYA OTORI

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

Pill Count

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Optimal cut-off points for adherence measure among patients with type 2 diabetes in primary care clinics: a retrospective analysis

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622321990264 ◽

2021 ◽

Vol 12 ◽

pp. 204062232199026

Author(s):

Ming Tsuey Lim ◽

Norazida Ab Rahman ◽

Xin Rou Teh ◽

Chee Lee Chan ◽

Shantini Thevendran ◽

...

Keyword(s):

Type 2 Diabetes ◽

Primary Care ◽

Medication Adherence ◽

Poor Adherence ◽

Adherence Measure ◽

Primary Care Clinics ◽

Assessment Period ◽

Hba1c Target ◽

Optimal Adherence

Background: Medication adherence measures are often dichotomized to classify patients into those with good or poor adherence using a cut-off value ⩾80%, but this cut-off may not be universal across diseases or medication classes. This study aimed to examine the cut-off value that optimally distinguish good and poor adherence by using the medication possession ratio (MPR) and proportion of days covered (PDC) as adherence measures and glycated hemoglobin (HbA1c) as outcome measure among type 2 diabetes mellitus (T2DM) patients. Method: We used pharmacy dispensing data of 1461 eligible T2DM patients from public primary care clinics in Malaysia treated with oral antidiabetic drugs between January 2018 and May 2019. Adherence rates were calculated during the period preceding the HbA1c measurement. Adherence cut-off values for the following conditions were compared: adherence measure (MPR versus PDC), assessment period (90-day versus 180-day), and HbA1c target (⩽7.0% versus ⩽8.0%). Results: The optimal adherence cut-offs for MPR and PDC in predicting HbA1c ⩽7.0% ranged between 86.1% and 98.3% across the two assessment periods. In predicting HbA1c ⩽8.0%, the optimal adherence cut-offs ranged from 86.1% to 92.8%. The cut-off value was notably higher with PDC as the adherence measure, shorter assessment period, and a stricter HbA1c target (⩽7.0%) as outcome. Conclusion: We found that optimal adherence cut-off appeared to be slightly higher than the conventional value of 80%. The adherence thresholds may vary depending on the length of assessment period and outcome definition but a reasonably wise cut-off to distinguish good versus poor medication adherence to be clinically meaningful should be at 90%.

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