DIABETES MELLITUS; Correlation of treatment satisfaction parameters, educational status and therapy type with adherence in type-II diabetes mellitus

摘要

Objectives: Diabetes Mellitus being a major issue faced by developingcountries like Pakistan. Non-adherence is a major issue in achieving a desired therapeuticgoal. This study aims at determining relation with the drug non-adherence associated with thetreatment 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 Diabetesclinic, Nishtar hospital, Multan. Total 242 diabetic patients were studied over a period of 10months. Methodology: The inclusion criteria was set as patients who have been diagnosedwith Diabetes Type II and had been on oral hypoglycemic medications for about last 5 monthsor more. Those patients who were diagnosed with Type I diabetes and Type II diabetesless than 5 months were not included in the study. Also those patients who were on Insulintherapy were also excluded. Socio-demographic data was obtained along with therapy typeand 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 formedication. 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. Meanage 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.Themean 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 andsatisfaction= 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 beovercome in patients to achieve appropriate glucose levels. Significant factors affecting theadherence levels were Illiteracy, Side effects, convenience and satisfaction of the patient. Publicawareness campaigns and regular clinic visits should be encouraged. Drugs having lower sideeffects,higher satisfaction levels and combined generics for once daily dosing having greaterconvenience should be used.