2026· Asian Journal of Medical Research and Health Sciences· Vol 04, pp. 2598-2603· 0 citations
TL;DR
Key modifiable factors such as depression, pill burden, and side effects were identified as independent predictors of poor adherence, and key modifiable factors such as depression, pill burden, and side effects were identified as independent predictors of poor adherence.
Abstract
Background:Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder requiring lifelong pharmacotherapy and lifestyle modifications. Despite the availability of effective therapies, poor medication adherence remains a significant barrier to achieving optimal glycemic control, leading to increased morbidity, mortality, and healthcare costs. Identifying the factors that influence adherence is crucial for developing effective interventions.Objective:To prospectively evaluate the factors affecting medication adherence in patients with T2DM.Methods:This prospective, observational study was conducted at the Department of Medicine of a tertiary care hospital. A total of 160 patients with T2DM on oral hypoglycemic agents for at least one year were enrolled. Baseline demographic, socioeconomic, and clinical data were collected. Medication adherence was assessed at baseline and at the 6-month follow-up using the validated Morisky Medication Adherence Scale (MMAS-8). Glycemic control was measured via HbA1c levels. Patients were categorized as having high, medium, or low adherence. Multivariate logistic regression analysis was performed to identify independent predictors of poor adherence.Results:Of the 160 enrolled patients, 152 completed the six-month follow-up (dropout rate: 5%). The mean age was 56.4 ± 11.2 years, with a slight male predominance (56.6%). At baseline, only 28.3% (n=43) of patients had high adherence. At the 6-month follow-up, the number of patients with high adherence had significantly declined to 23.0% (n=35) (p=0.03). Factors significantly associated with poor adherence on multivariate analysis included: the presence of depressive symptoms (AOR: 3.2, 95% CI: 1.6-6.4, p=0.001), a higher pill burden (>5 pills per day) (AOR: 2.8, 95% CI: 1.4-5.6, p=0.004), lower monthly family income (AOR: 2.1, 95% CI: 1.1-4.1, p=0.02), and the experience of medication-related side effects (AOR: 2.4, 95% CI: 1.2-4.8, p=0.01). There was a strong correlation between lower adherence scores and higher HbA1c levels at the 6-month follow-up (r = 0.62, p<0.001).Conclusion:The rate of medication non-adherence in T2DM patients is alarmingly high and tends to decline over time. Key modifiable factors such as depression, pill burden, and side effects were identified as independent predictors of poor adherence. A multidisciplinary approach involving psychological support, regimen simplification, and proactive side-effect management is essential to improve adherence and, consequently, clinical outcomes in this patient population.
Type 2 Diabetes Mellitus (T2DM) remains a major public health concern in Indonesia due to its high prevalence and potential to cause various long-term complications when glycemic control is not adequately maintained. Medication adherence and barriers to treatment are important factors that may influence therapeutic outcomes. This study investigated medication adherence, insulin-related treatment barriers, and their association with glycemic outcomes among patients with T2DM at RSPAU dr. Suhardi Hardjolukito Hospital, Yogyakarta. Employing a cross-sectional approach, this research gathered data between September and October 2024. Criteria for eligibility included adult individuals with T2DM who were treated with oral antidiabetic agents, insulin, or both and provided informed consent. Medication-taking behavior was evaluated by utilizing the Medication Adherence Report Scale (MARS-5) framework, while barriers to insulin therapy were evaluated using a specific questionnaire. Associations between adherence status and glycemic parameters were examined through Fisher's Exact Test. A total of 73 patients participated, most of whom were receiving oral therapy (65.8%), a combination of metformin and glimepiride (19.2%), or metformin and acarbose (11.0%). Among insulin users, the majority had low barriers to insulin use (92.0%). Statistical analysis yielded p-values of 0.038 and 0.000 for the associations between medication adherence and fasting blood glucose as well as HbA1c levels, and for the relationship between adherence status and random blood glucose measurements, a p-values = 0.542 was obtained. The findings demonstrated that therapeutic compliance is significantly correlated with both HbA1c and fasting blood sugar levels among individuals suffering from type 2 diabetes mellitus at RSPAU dr. Suhardi Hardjolukito Hospital, Yogyakarta. These results highlight the contribution of adherence behavior to successful glycemic management. Therefore, healthcare professionals are advised to implement strategies that encourage medication adherence to optimize glycemic control.
Mita Ardila, Haafizah Dania, Siswandi et al.· Pharmaciana· 0 citations
Objective: This study aimed to assess treatment adherence according to antidiabetic treatment regimens and its associations with medication burden and clinical outcomes in patients with type 2 diabetes mellitus (T2DM).Methods: This cross-sectional study was conducted between January and April 2024 in the endocrinology department of a tertiary care hospital. Adult patients diagnosed with T2DM for at least one year were included. Sociodemographic data, comorbidities, diabetes-related complications, treatment and lifestyle characteristics, laboratory parameters (HbA1c and C-peptide), and self-reported adherence were recorded. Treatment adherence was assessed using the validated Turkish version of the Treatment Adherence in Type 2 Diabetes Mellitus (TAT2DM) Scale. The study was approved by the XXX Ethics Committee (approval no: 2023/5237).Results: The study included 198 patients with T2DM. Hypertension was the most common comorbidity, and diabetic peripheral neuropathy was the most frequent complication. The mean TAT2DM score was 85.2 ± 9.2. HbA1c levels were positively correlated with the total number of medications, oral antidiabetic drugs (OADs), and insulin products (p < 0.001), while C-peptide levels were negatively correlated with the number of insulin products (p = 0.010). The total TAT2DM score was negatively associated with the number of insulin products (p = 0.008) and adherence was significantly higher among patients who exercised regularly (p = 0.024). Treatment adherence and HbA1c levels differed significantly across antidiabetic regimens, with higher adherence and HbA1c observed in patients receiving combined insulin and OAD therapy (p
Ahmet Çakır, Hasan Memiş, Ahsen Telli et al.· Pharmata· 0 citations
BACKGROUND
Treatment adherence in type 2 diabetes(T2D) is essential for glycemic control and preventing complications. The aim of the present study was to determine the status of adherence behaviors to diabetes treatment and identify sociodemographic factors associated with these behaviors in patients with type 2 diabetes in southern Iran.
METHODS
This cross‑sectional study was conducted from November 2022 to January 2023 among patients with type 2 diabetes attending a diabetes clinic in Bandar Abbas. A total of 396 patients were included using systematic sampling. Data were collected using a validated researcher-made questionnaire that assessed sociodemographic characteristics and five treatment-adherence behaviors, including regular medication use, blood glucose monitoring, physician visits, dietary adherence, and physical activity. Associations between demographic and disease-related factors and the outcomes were assessed using multivariable logistic regression, and crude and adjusted odds ratios with 95% confidence intervals were reported. All statistical analyses were performed using SPSS version 24.
RESULTS
Participants (n = 396) had a mean age of 54.4 ± 11.5 years (range: 27-78). Among the treatment adherence behaviors, regular medication use showed the highest level of adherence (86.9%), while regular physical activity had the lowest level (49.7%). In the multivariable analysis, frequent medication use was associated with older age, higher education, higher economic status, and diabetes duration of 6-10 years. Frequent blood glucose monitoring was associated with female sex, older age, and diploma education. Frequent physician visits were associated with older age and longer diabetes duration. Dietary adherence was associated with university education, and frequent physical activity was associated with living alone.
CONCLUSIONS
The findings suggest that adherence to treatment among patients with T2Dvaries across different domains and is shaped by individual, social, and clinical factors. It seems that, Lifestyle behaviors such as diet and physical activity are largely influenced by social and environmental contexts, whereas healthcare‑seeking behaviors are more closely linked to disease severity and patients' interaction with the health system.
Zahra Hosseini, Nahid Shahabi, A. Ghanbarnejad et al.· BMC Public Health· 0 citations
Diabetes mellitus is a rapidly growing public health concern globally, and medication adherence plays an important role in managing diabetes. This study was carried out with the purpose of assessing patient adherence to anti-diabetic medication among the people of the Hail region, which is associated with long-term complications due to diabetes. This cross-sectional study was conducted from May to June 2023 using an online questionnaire among 254 diabetes patients in the Hail region of Saudi Arabia. The questionnaire assessed socio-demographic factors and medication adherence, which was scored and categorized into low, intermediate, and high adherence. Data were analyzed using Mann–Whitney U and Kruskal–Wallis tests to identify associations. Over 84% of participants showed low to intermediate adherence, whereas only 15.8% were highly adherent. Treatment inconvenience, forgetfulness, and discontinuation due to side effects were among the main barriers to medication adherence. There was a strong correlation (P < .001) between improved medication adherence and age, education, and marital status. However, gender and body weight did not show any significant correlations. Diabetes patients in Hail have suboptimal medication adherence, which is impacted by behavioral and demographic factors. It is essential to address barriers through patient education, regimen simplification, and culturally tailored strategies to improve adherence and avoid long-term complications.
Summary Background Type 2 diabetes is a major risk factor for cardiovascular disease, and reducing this excess risk is a central goal of clinical management. Sustained adherence to glucose-lowering medication is considered a key component of this strategy. However, long-term patterns of medication-taking behavior in real-world settings, and their relationship with cardiovascular outcomes, remain insufficiently characterized. Methods We conducted a nationwide cohort study of Danish adults with newly diagnosed type 2 diabetes who initiated non-insulin glucose-lowering medication between 2005 and 2012. Medication adherence was estimated from pharmacy dispensing data, and group-based trajectory modeling was used to identify longitudinal adherence patterns. The primary outcome was a composite cardiovascular outcome including ischemic heart disease, stroke, or heart failure. Associations between adherence trajectories and cardiovascular outcomes over 10 years of follow-up were assessed with Cox proportional-hazards models. Findings Among 79,510 individuals with newly diagnosed type 2 diabetes (median age, 61 (IQR: 52–69); 57% men), we identified three long-term adherence trajectories defined by high (n = 32,912; 41%), intermediate (n = 25,822; 33%), and low (n = 20,776; 26%) adherence. During follow-up, 15,276 cardiovascular events occurred. Compared with the high-adherence group, adjusted hazard ratios for the composite cardiovascular outcome were 1.07 (95% CI, 1.03–1.12) and 1.27 (95% CI, 1.21–1.33) in the intermediate- and low-adherence groups, respectively. Participants with high adherence remained free of cardiovascular events for an average of 220 more days (95% CI, 204–237) over 10 years. Associations were largely driven by ischemic heart disease, with no significant associations for heart failure. Interpretation Long-term adherence to glucose-lowering medication was associated with lower cardiovascular rate and longer event-free survival time among individuals with newly diagnosed type 2 diabetes. Funding Novo Nordisk Foundation and the European Innovation Council.
Lise B. Nielsen, A. Bartholdy, Tri-Long Nguyen et al.· The Lancet Regional Health -...· 0 citations
Type II Diabetes Mellitus is a chronic disease that requires long-term management, one of which is medication adherence to maintain controlled blood glucose levels. Non-adherence to antidiabetic medication may lead to uncontrolled blood glucose levels and increase the risk of complications. This study aims to determine a correlation between medication adherence and blood glucose levels in patients with Type II Diabetes Mellitus at Sawah Lebar Health Center, Bengkulu City in 2025. This study employed a quantitative correlational design with a cross-sectional approach. Medication adherence was measured using the Morisky Medication Adherence Scale-8 (MMAS-8) questionnaire, while blood glucose levels were measured through Random Blood Glucose (RBG) examination using a glucometer. The population of this study consisted of all patients with Type II Diabetes Mellitus receiving treatment at Sawah Lebar Health Center, with a total sample of 49 respondents. The results showed that most respondents had a moderate level of medication adherence, accounting for 21 respondents (42.9%). Based on the results of random blood glucose examinations, the majority of respondents had abnormal (high) blood glucose levels, totaling 35 respondents (71.4%). The statistical analysis using the Chi-Square test showed a p-value of 0.000 (p < 0.05), indicating a significant correlation between medication adherence and blood glucose levels among patients with Type II Diabetes Mellitus at Sawah Lebar Health Center, Bengkulu City in 2025. The researchers recommend that the Health Center use the findings of this study as a reference to improve healthcare service programs, particularly in enhancing medication adherence to support normal blood glucose levels among patients with Type II Diabetes Mellitus
