Medication adherence and glycemic control status among people with diabetes seeking care from a tertiary care teaching hospital, south India

Abstract

Introduction: Good medication adherence and glycemic control are essential to reduce complications of diabetes and its adverse outcomes. Hence, we aimed to assess the medication adherence and glycemic control status among people with diabetes (PWDs). Methods: This hospital-based cross-sectional study was conducted among persons with type 2 diabetes aged ≥18 years and on treatment in a public tertiary care center for at least one year. Medication adherence was assessed using Morisky, Green, and Levine Adherence scale (MGL). A fasting blood sugar (FBS) > 125 mg/dl or not checked blood sugar in the past year was defined as ‘unsatisfactory’ FBS glycemic control. Log binomial regression was performed to find the predictors of poor medication adherence and unsatisfactory FBS control. Results: A total of 1002 PWDs were included. About 62% were males, 81% from rural areas, 69% were on treatment for diabetes for more than five years, and half were on insulin (49%). Poor medication-adherence (MGL score ≥1) was seen in 39% (95% CI 36.5–42.6%), and unsatisfactory FBS was in 58% (95% CI 55.1–61.4). Female gender (APR = 1.44, p=<0.001), daily waged workers (APR = 1.70, p = 0.009), and tobacco users (APR = 1.46, p = 0.001) had poor medication adherence compared to their counterparts. PWDs aged above 45 years, female gender (APR = 1.18, p = 0.012), on insulin therapy (APR = 1.17, p = 0.004), alcohol use (APR = 1.14, p = 0.019), and poor adherence to medications (APR = 1.20, p < 0.001) were significantly associated with unsatisfactory FBS control. Conclusions: Prevalence of poor medication adherence was 39%, and more than half of the PWDs had unsatisfactory FBS control.

Keywords

• Adherence
• Blood sugar control
• Diabetes outcome
• Fasting blood sugar