A Cross-Sectional Study Assessing Medication Adherence to Diabetes Mellitus Treatment Among Adults in A Tertiary Care Hospital in the National Capital Region, Delhi

Prem  Kumar; Anshu Singh; Mahak  Lamba; Muskan  Garg

doi:10.55489/njcm.160520254900

Authors

Prem Kumar Department of General Medicine, School of Medical Sciences and Research, Sharda University, Greater Noida, India
Anshu Singh Department of Community Medicine, School of Medical Sciences and Research, Sharda University, Greater Noida, India
Mahak Lamba Department of General Medicine, King George Medical College, Lucknow, India
Muskan Garg Department of General Medicine, School of Medical Sciences and Research, Sharda University, Greater Noida, India

DOI:

https://doi.org/10.55489/njcm.160520254900

Keywords:

Diabetes, Cross-sectional, Adherence, Adults, North India

Abstract

Introduction: India has earned the dubious distinction of being the diabetic capital of the world. Poor adherence to diabetes treatment is common now a days that can lead to severe health complications and is related to increased morbidity and mortality. Keeping this in mind, the present study had been planned to assess medication adherence to diabetes mellitus treatment among adults in a tertiary care hospital.

Methodology: A descriptive cross-sectional study was conducted among adult patients attending the outpatient department of tertiary care hospital from October 2022 to September 2023 on 320 type 2 diabetes mellitus patients (T2DM) using the Morisky Medication Adherence Scale. The Statistical Package for Social Sciences (SPSS) software was used for statistical analyses.

Results: In 320 study subjects, the mean age came out to be 43+12.5 years. Prevalence of poor adherence was found to be 62% (95% confidence interval = 58.2-69.3). The average MMAS score came out to be 4.22. Of the total 320 diabetic patients, around 50.3% (161) came into low, 25.6% (82) in medium, and 24.1% (77) were in high adherent group respectively. Age, education, tobacco, alcohol consumption and suffering from any other chronic illness had significant effects on the adherence to treatment of T2DM.

Conclusion: Poor adherence to diabetes was found. Adherence to medication needs to be improved for better control and management of disease.

References

IDF Diabetes Atlas. International Diabetes Federation Brussels. 10th edition 2021. p 5,94-95.

World Health Organization (WHO). Adherence to long-term therapies: evidence for action. Geneva: WHO; 2003.p71-82.

ICMR. Assessment of Burden of NCDs. Indian Council of Medical Research.New Delhi ,India. 2006.pg 6,7.

Cramer JA, Okikawa J, Bellaire S, Clauson P: Compliance with inhaled insulin treatment using the AERx(registered trademark) iDMS insulin diabetes management system. Diab Technol Ther 2004, 6(6):800-807. DOI: https://doi.org/10.1089/dia.2004.6.800 PMid:15684632

Vermeire EIJJ, Wens J, Van Royen P, Biot Y, Hearnshaw H, Lindenmeyer A: Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus. Cochrane Database Syst Rev 2005;2:CD003638. DOI: https://doi.org/10.1002/14651858.CD003638.pub2 PMid:15846672 PMCid:PMC9022438

Morisky DE, Ang A, Krousel-Wood M, et al. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich) 2008;10:348-54. DOI: https://doi.org/10.1111/j.1751-7176.2008.07572.x PMid:18453793 PMCid:PMC2562622

Sankar UV, Lipska K, Mini GK. The Adherence to Medications in Diabetic Patients in Rural Kerala. Asia Pacific Journal Of Public Health .2015;27(2):13-23. DOI: https://doi.org/10.1177/1010539513475651 PMid:23417905

Singh R, Kumari P, Prashar A, Sardana O, Singh V. Assessment of medication adherence among type-2 diabetes mellitus in a tertiary care hospital of North India. Environ Sci Pollut Res Int. 2022 Apr;29(17):24951-24955. DOI: https://doi.org/10.1007/s11356-021-17434-1 PMid:34826085

Ho PM, Rumsfeld JS, Masoudi FA, McClure DL, Plomondon ME, Steiner JF,Magid DJ: Effect of medication non adherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med 2006, 166(17):1836-1841. DOI: https://doi.org/10.1001/archinte.166.17.1836 PMid:17000939

Puder JJ, Keller U. Quality of diabetes care: Problem of patient or doctor adherence? Swiss Med Wkly. 2003;133:530-12. Nagpal J, Bhartia A. Quality of diabetes care in the middle- and high-income group populace - the Delhi Diabetes Community (DEDICOM) survey. Diabetes Care. 2006;29:2341-2348. DOI: https://doi.org/10.2337/dc06-0783 PMid:17065665

Acharya AS, Gupta E, Prakash A, Singhal N. Self-reported Adherence to Medication among Patients with Type II Diabetes Mellitus attending a Tertiary Care Hospital of Delhi. J Assoc Physicians India. 2019 ;67(4):26-29.

Masaryková L, Tesař T, Lehocká U, Bernáthová K. Evaluation of adherence to treatment in patients suffering from diabetes mellitus.Ceska a Slovenska Farmacie 2020;69(2):67-74. DOI: https://doi.org/10.36290/csf.2020.011 PMid:32545985

Shobhana R, Begum R, Snehalatha C, Vijay V, Ramachandran A. Patients adherence to diabetes treatment. J Assoc Phys India. 1999;47:1173-5.

Asheq A, Ashames A, Al-Tabakha M, Hassan N, Jairoun A. Medication adherence in type 2 diabetes mellitus patients during Covid-19 pandemic: a cross-sectional study from the United Arab Emirates. F1000Res. 2021;10:435. DOI: https://doi.org/10.12688/f1000research.51729.2 PMid:34925767 PMCid:PMC8649966

Sharma D, Goel NK, Cheema YS, Garg K. Medication Adherence and its Predictors among Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study. Indian J Community Med. 2023 ;48(5):781-785. DOI: https://doi.org/10.4103/ijcm.ijcm_744_22 PMid:37970170 PMCid:PMC10637603

Islam SMS , Biswas T ,Bhuiyan FA , Mustafa K , Islam A .Patients' perspective of disease and medication adherence for type 2 diabetes in an urban area in Bangladesh: a qualitative study BMC Res Notes 2017;10:131. DOI: https://doi.org/10.1186/s13104-017-2454-7 PMid:28327202 PMCid:PMC5361713

Al-Qazaz, H.K., Sulaiman, S.A., Hassali, M.A. et al Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes. Int J Clin Pharm 2011; 33: 1028. DOI: https://doi.org/10.1007/s11096-011-9582-2 PMid:22083724

Hashmi NR, Khan SA. Adherence to Diabetes Mellitus Treatment Guidelines From Theory To Practice: The Missing Link. J Ayub Med Coll Abbottabad. 2016 ;28(4):802-808.

Venkataraman K, Kannan AT, Mohan V. Challenges in diabetes management with particular reference to India. Int J Diabetes Dev Ctries. 2009 Jul;29(3):103-9. DOI: https://doi.org/10.4103/0973-3930.54286 PMid:20165646 PMCid:PMC2822213