Evaluation of Adherence to Therapy in Patients of Type 2 Diabetes Mellitus

Objective: To evaluate adherence to therapy and study factors associated with non-adherence in patients of type 2 diabetes mellitus (DM). Methods: A prospective, cross-sectional, questionnaire based study was conducted in a tertiary care teaching hospital. 150 patients suffering from type 2 DM since six months or more were interviewed using self-designed, semistructured questionnaire to get information about adherence to medication, diet/exercise schedule and self-monitoring of blood glucose. Morisky medication adherence questionnaire was used to calculate overall adherence. Results: Average number of medicines taken by each patient daily was 4.75 ± 1.73 (mean + SD). 70% patients reported non-adherence to medication schedule. Not buying all medicines (58.66%), not taking prescribed dose of medicines (34%), taking additional non-prescribed medicines (30%) and not taking medicines for required duration (25.33%) were common types of nonadherence. Unawareness about need of each medicine (55.66%), forgetfulness (50.66%) and high cost (43.33%) were the common causes of non-adherence. In Morisky medication adherence questionnaire high, medium and low adherence was reported by 0%, 26% and 74% of patients, respectively. Moderately positive correlation was observed between poor adherence and number of concurrent illnesses, number of medicines taken and female gender. Regular monitoring of blood glucose and diet schedule was followed by 46% and 68% patients respectively. Conclusion: Since, not buying all medicines, which was mostly due to high cost was the commonest type of non-adherence, measures to provide free medicines to non-affording patients need to be implemented. Majority of patients were not aware about need of taking each medicine, hence, creating awareness about the same is essential for improving adherence to therapy.