Assessment of Medication Adherence and its Association with Glycemic Control among Type-2 Diabetes Mellitus (T2DM) Patients in Gaza - Palestine

Almadhoun, Mahmoud (2017) Assessment of Medication Adherence and its Association with Glycemic Control among Type-2 Diabetes Mellitus (T2DM) Patients in Gaza - Palestine. Masters thesis, Al Azhar University Gaza.

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Background and Objectives: Diabetes mellitus (DM) is a common serious health problem. DM is considered the third leading cause of death among chronic diseases in Gaza Strip (PHIC-MOH, 2015b). Medication adherence is a key determinant of therapeutic success and attainment of the required glycemic control. No studies have previously been conducted about medication adherence among T2DM patients in Gaza. The purpose of this study was to assess medication adherence and its association with glycemic control among T2DM patients. Furthermore, this study examined the association between medication adherence and patients’ socio-demographic characteristics, patients' diabetic history and co-morbidities, patients' medications history and their pattern of anti-diabetic drugs prescribing, patients' care and education characteristics, patients' diabetes knowledge and patients’ beliefs about medicines. Methodology: One hundred forty eight T2DM patients from Al-Rimal Martyrs clinic, Gaza were included in the current cross sectional study. The study used Morisky eight-item Medication Adherence Scale (MMAS-8) to assess medication adherence. Last value of HbA1c test was used to assess glycemic control. Michigan diabetes knowledge test (MDKT) was used to assess DM-related knowledge. Beliefs about Medicines Questionnaire (BMQ) was used to assess beliefs about medicines. Patients' medical records were used to collect the patients’ demographic and clinical information. Chi-square test, Binary logistic regression test, Multivariate logistic regression and Odds ratio (OR) at 95% confidence interval were used to examine the relationship between medication non-adherence and different variables. Results: Five patients (3.3%) were classified as high adherents, while (65, 43.9%) of patients were medium adherents and (78, 52.7%) of patients were low adherents according to MMAS-8. The mean adherence score for patients was 5.5± 1.4. Sixty five (43.92%) patients were good glycemic controlled (HbA1c ≤ 7). The majority of patients (64.2%) had low level of knowledge about DM (MDKT scores < 7). The mean score of MDKT was 7.02 ± 1.67. Patients were strongly endorsed that their anti-diabetic medications were necessary for their current and future health (mean score in specific-necessity scale was 17.8 ± 3.62). Patients had medium concerns about the adverse consequences of taking anti-diabetic medications on regular basis (mean score in specific-concerns scale was 12.4 ± 3.63). Patients had medium negative views about medicines as a whole and a tendency to see medicines as fundamentally harmful and addictive poisons (mean score in general-harm scale was 12.5 ± 3.50). Patients had medium negative views about the way in which medicines were prescribed and belief that medicines were iv overused by physicians (mean score in general-overuse scale was 12.3 ± 2.79). There was a significant association between medication non-adherence and poor glycemic control (P-value< 0.001). Factors significantly associated with medication non-adherence were unmarried status (P value = 0.012), diet non-compliance status (P value = 0.003), patients' negative beliefs about medicines as a whole (P value = 0.05) and getting education about DM (P value = 0.011). Conclusion: Most patients in this study were medication non-adherents and poor glycemic controlled. Moreover, Medication non-adherence was significantly associated with poor glycemic control. Raising awareness of patients about medication adherence and improving communication with health care professionals could improve adherence level. Key words: medication adherence, T2DM, glycemic control.

Item Type: Thesis (Masters)
Subjects: Q Science > Q Science (General)
Depositing User: أ. طارق زياد عبد حنونة
Date Deposited: 18 Aug 2020 08:39
Last Modified: 18 Aug 2020 08:39

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