Factors associated with non-adherence to antidiabetic treatment in patients with diabetes mellitus type 2

Abstract

Introduction: lack of therapeutic adherence in chronic non-communicable diseases, such as diabetes mellitus, is a serious global problem that significantly affects patients' quality of life and leads to adverse disease outcomes. Lack of knowledge of the related factors prevents the possibility of acting on the origin of this problem.

Objective: to determine the factors associated with non-adherence to antidiabetic treatment in patients with Diabetes Mellitus Type 2 in the Clinic service of the Vicente Corral Moscoso Hospital in the city of Cuenca during the period 2019-2020.

Methodology: a cross-sectional analytical study was carried out. The sample was 204 patients applying the formula for finite populations. To establish therapeutic adherence, the Morisky – Green – Levine Test was used, the Patient Health Questionnaire (PHQ – 9) test was used to determine depression, and the Fagerström test was used to determine tobacco dependence. The data were analyzed in the PSPP 1.2.0 program, using the prevalence ratio to measure the association. The bioethics committee approved the study.

Results: the mean age was 68.88 ± 16.37 years. The frequency of non-adherence to the treatment was 70.6%. The associated factors were: use of 4 or more drugs (PR 3.99 IC 2.77 - 6.99), smoking (PR 2.61 IC 1.49 - 4.58), distance to the health center was more than 30 minutes (PR 2.81 IC 1.79 - 4.4), rural origin (PR 2.26 IC 1.07 - 4.77), depression (PR 2.14 IC 1.5 - 3.06), time of diagnosis more than ten years (PR 2.0 IC 1.4 - 2.87) and use of oral treatment (PR 1.7 IC 1.19 - 2.43); all statistically significant (p <0.05).

Conclusions: the lack of adherence to antidiabetic treatment was associated with the concomitant use of 4 or more medications, smoking, distance to the health center more than or equal to 30 minutes, a rural origin, depression, time of diagnosis more than ten years, and the use of oral treatment.