Medication non-adherence in patients with type 2 diabetes: a cross-sectional study in Morocco

medication non-adherence in patients with type 2 diabetes substantially contributes to poor glycemic control and increases the risk of complications. This study aimed to assess the prevalence of medication non-adherence and to identify its associated factors among Moroccan patients with type 2 diabetes.

a cross-sectional study was conducted in the Endocrinology Department of Ibn Rochd University Hospital in Casablanca, Morocco. A total of 329 adult patients with type 2 diabetes were included. Medication adherence was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8). Bivariate logistic regression was performed to examine associations between non-adherence and socio-demographic, clinical, treatment, and behavioral-related factors.

among the participants, 52.6% exhibited low adherence, followed by 20.4% with moderate adherence and 27.1% with high adherence to antidiabetic medications. Socio-demographic characteristics, including age, gender, marital status, and education, showed no significant association with non-adherence. Several clinical and behavioral factors, however, were significantly related to adherence patterns. Higher odds of non-adherence were observed among patients who did not benefit from therapeutic education (p=0.009), individuals not performing self-monitoring of blood glucose (p<0.001), and those using phytotherapy (p=0.03). Additional determinants of poor adherence included higher out-of-pocket medication costs (p=0.043), drug shortages in health facilities (p=0.013), forgetfulness (p<0.001), absence of diabetic symptoms (p<0.001), and psychological barriers such as mistrust in physicians (p<0.001). Conversely, better adherence was associated with the combined use of oral antidiabetic drugs and insulin, follow-up with a general physician (p=0.036), dietary compliance (p<0.001), and regular physical activity (p=0.021).

medication non-adherence remains highly prevalent among patients with type 2 diabetes. Our findings highlight the importance of strengthening therapeutic education, improving access to medications, and promoting healthy lifestyle behaviors to enhance adherence. Targeted interventions addressing both behavioral and healthcare system-related barriers are essential to improve long-term diabetes outcomes in the Moroccan context.