Medication adherence among patients with Type 2 diabetes: A mixed methods study.

Area of Science:

• Endocrinology
• Public Health
• Behavioral Science

Background:

• Oral hypoglycemic agents (OHAs) are crucial for managing Type 2 diabetes.
• Patient adherence to OHAs is essential for effective disease management and optimal health outcomes.
• Suboptimal adherence to OHAs remains a significant challenge in Type 2 diabetes care.

Purpose of the Study:

• To assess the level of adherence to oral hypoglycemic agents (OHAs) among patients with Type 2 diabetes.
• To explore the factors influencing OHA adherence behavior in this patient population.
• To identify determinants for developing future interventions to improve OHA adherence.

Main Methods:

• A mixed-methods approach was employed, combining a cross-sectional survey and qualitative interviews.
• The Morisky Medication Adherence Scale (Arabic version) was used for quantitative assessment with 395 patients.
• Semi-structured interviews guided by the Theoretical Domain Framework were conducted with 20 patients to explore adherence determinants.

Main Results:

• Only 40% of patients achieved high adherence to OHAs.
• Lower adherence was significantly associated with younger age (OR 1.084), a higher number of non-OHA medications (OR 0.848), and elevated HbA1c levels (OR 0.808).
• Qualitative findings revealed that behavioral factors (e.g., medication scheduling), social influences (e.g., family support), and knowledge gaps significantly impact adherence.

Conclusions:

• This study elucidates key reasons for low OHA adherence in Type 2 diabetes patients.
• The identified theoretically-derived determinants underscore the complexity of OHA adherence.
• Findings provide a strong foundation for developing targeted interventions to enhance adherence and improve patient outcomes.