Predictors of non-adherence to pharmacotherapy in patients with type 2 diabetes

Background The prevalence of diabetes in Jordan is among the highest in the world, making it a particularly alarming health problem there. It has been indicated that poor adherence to the prescribed therapy lead to poor glycemic control and enhance the development of diabetes complications and unnecessary hospitalization. Objective To explore factors associated with medication nonadherence in patients with type 2 diabetes in Jordan. Findings would help guide the development of future pharmaceutical care interventions for patients with type 2 diabetes. Setting This study was conducted in an outpatient diabetes clinic at the Royal Medical Services Hospital. Method Variables including sociodemographics, disease and therapy factors, diabetes knowledge, health-related quality of life in addition to adherence assessment were collected for 171 patients with type 2 diabetes using medical records, custom-designed and validated questionnaires. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with type 2 diabetes in Jordan. Main outcome measure Variables which significantly and independently associated with medication nonadherence in patients with type 2 diabetes in Jordan. Results Patients were found four times less likely to adhere to their medications with each unit increase in the number of prescribed medications (OR = 0.244, CI = 0.08-0.63) and nine times less likely to adhere to their medications if they received more than once daily dosing of diabetic medication (OR = 0.111, CI = 0.04-2.01). Patients in the present study were also approximately three times less likely (OR = 0.362, CI = 0.24-0.87) and twice less likely (OR = 0.537, CI = 0.07-1.31) to adhere to their medications if they reported having concerns about side effects and if they were taking metformin therapy respectively. Finally, participants were found twice more likely to adhere to medications if they had one or more Microvascular complication (OR = 0.493, CI = 0.08-1.16). Conclusion Simplifying dosage regimen, selecting treatments with lower side effects along with an emphasis on diabetes complications should be taken into account in future interventions designed to improve health outcomes for patients with type 2 diabetes.