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Factors associated with medication adherence among people with type 2 diabetes in Indonesia: A multicenter
Indriastuti Cahyaningsih1, M Rifqi Rokhman2, Nurul Maziyyah3
1Department of PharmacoTherapy, Epidemiology, and Economics, Groningen, the Netherlands; Department of Pharmacist Professional Education, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia.
Purpose:
To disentangle the relationships of patient characteristics, diabetes knowledge, general beliefs about medication, specific beliefs about glucose-lowering medications and natural remedies, with adherence to glucose-lowering medication adherence.
Methods:
This multicenter cross-sectional study was conducted across fifteen primary healthcare centers in Indonesia. Type 2 diabetes (T2D) patients (≥18 years) who consented to participate were included. Assessment tools included the adapted Diabetes Knowledge Questionnaire (DKQ), Beliefs about Medications Questionnaire (BMQ), and Medication Adherence Report Scale-5 (MARS-5). Structural equation modeling was employed.
Results:
A total of 328 patients with T2D participated (mean age 60.6 ± 8.9 years; diabetes duration 7.1 ± 6.2 years; 74.4% female). The final model showed that experiencing side effects from glucose-lowering medication was associated with lower medication adherence (β = -0.234), whereas educational level showed an association, with only medium-level education being associated with higher adherence (β = 0.135). General beliefs about medication overuse (β = -0.230) and specific beliefs about the necessity of glucose-lowering medication (β = 0.195) were associated with adherence during model selection. General beliefs about medication overuse and specific beliefs about medication necessity were positively correlated (β = 0.413). Diabetes knowledge and natural remedy beliefs were not associated with medication adherence.
Conclusions:
General and specific beliefs about medications, as well as experiences of side effects, were associated with adherence to glucose-lowering medications. Interventions should focus on addressing these beliefs and managing side effects. Given the relationships between such factors, personalized approaches may be necessary to improve adherence.
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