Adherence to oral anti-diabetic drugs among patients attending a Ghanaian teaching hospital

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Suliasnaia P. Bruce
Franklin Acheampong
Irene Kretchy


Medication Adherence, Diabetes Mellitus, Type 2, Risk Factors, Logistic Models, Ghana


Background: The burden of diabetes mellitus, especially Type-2, continues to increase across the world. Medication adherence is considered an integral component in its management. Poor glycemic controls due to medication nonadherence accelerates the development of long-term complications which consequently leads to increased hospitalization and mortality.

Objective: This study examined the level of adherence to oral antidiabetic drugs among patients who visited the teaching hospital and explored the probable contributory factors to non-adherence.

Methods: A cross-sectional descriptive study using systematic sampling to collect quantitative data was undertaken. Questionnaires were administered to out-patients of the medical department of a teaching hospital in Ghana. Logistic regression was performed with statistical significance determined at p<0.05.

Results: A total of 200 diabetic patients participated in the study. Using the Morisky Medication Adherence scale, the level of adherence determined was 38.5%. There were significant correlations between level of adherence and educational level [(OR)=1.508; (CI 0.805- 2.825), P=0.019), and mode of payment [(OR)=1.631; (CI 0.997- 2.669), P=0.05).

Conclusion: Adherence in diabetic patients was low among respondents and this can be improved through education, counseling and reinforcement of self-care. There were several possible factors that contributed to the low adherence rate which could benefit from further studies.

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1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-1053.

2. American Diabetes Association. Economic costs of diabetes in the U.S in 2007. Diabetes Care. 2008;31(3):596-615. doi: 10.2337/dc08-9017

3. Haynes RB, Taylor DW, Sackett DL. Compliance in Health care. Baltimore: The Johns Hopkins University Press; 1979.

4. Sabaté E. Adherence to Long-Term Therapies: Evidence for Action. Geneva: World Health Organization; 2003.

5. Bardel A, Wallander MA, Svärdsudd K. Factors associated with adherence to drug therapy: a population-based study. Eur J Clin Pharmacol. 2007;63(3):307-314.

6. Delamater AM. Improving patient adherence. Clin Diabetes. 2006;24(2):71-77. doi: 10.2337/diaclin.24.2.71

7. Amoah A. Comprehensive care in a low-income country: The Ghana Experience. Diabetes Voice. 2002;47(2):20-22.

8. Kalyango JN, Owino E, Nambuya AP. Non-adherence to diabetes treatment at Mulago Hospital in Uganda: prevalence and associated factors. Afr Health Sci. 2008;8(2):67-73.

9. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24(1):67-74.

10. Shams ME, Barakat EA. Measuring the rate of therapeutic adherence among outpatient with T2DM in Egypt. Saudi Pharm J. 2010;18(4):225-232. doi: 10.1016/j.jsps.2010.07.004

11. Hernández-Ronquillo L, Téllez-Zenteno JF, Garduño-Espinosa J, González-Acevez E. Factors associated with therapy noncompliance in type-2 diabetes patients. Salud Publica Mex. 2003;45(3):191-197.

12. Adisa R, Fakeye TO, Fasanmade A. Medication adherence among ambulatory patients with type 2 diabetes in a tertiary healthcare setting in Southwestern Nigeria. Pharm Pract (Granada). 2011;9(2):72-81.

13. Gimenes HT, Zanetti ML, Haas VJ. Factors Related to patient adherence to antidiabetic drug therapy. Rev Lat Am Enfermagem. 2009;17(1):46-51.

14. Kalyango JN, Owino E, Nambaya P. Non-adherence to diabetes treatment at Mulago Hospital in Uganda: prevalence and associated factors. Afr Health Sci. 2008;8(2):67-73.

15. Chua SS, Chua SP. Medication adherence and achievement of glycaemic targets in ambulatory type 2 diabetic patients. J Appl Pharm Sci. 2011;1(4):55-59.

16. Dailey G, Kim MS, Lian JF. Patient compliance and persistence with antihyperglycaemic drug regimens: evaluation of Medicaid patient population with type 2 diabetes mellitus. Clin Ther. 2001;23(8):1311-1320.

17. Dailey G, Kim MS, Lian JF. Patient compliance and persistence with antihyperglycaemic therapy: evaluation of a population of type 2 diabetic patients. J Int Med Res. 2002;30(1):71-79.

18. Melikian C, White TJ, Vanderplas A, Dezii CM, Chang E. Adherence to oral antidiabetic therapy in a managed care organization: a comparison of monotherapy, and fixed-dose combination therapy. Clin Ther. 2002;24(3):460-467.

19. Geok H, Anwar M, Wong PS. A Study on Compliance among Oral Hypoglycaemic Agents (OHA) Users at a public Hospital In Malaysia. 8th Asian Conference on Clinical Pharmacy. Surabaya, 2008.

20. Garay-Sevilla ME, Nava LE, Malacara JM, Huerta R, Díaz de León J, Mena A, Fajardo ME. Adherence to treatment and social support in patients with non-insulin diabetes mellitus. J Diabetes Complications. 1995;9(2):81-86.

21. Mansoor LE, Dowse R. Medicines information and adherence in HIV/AIDS patients. J Clin Pharm Ther. 2006;31(1):7-15.

22. Smith DH, Kramer JM, Perrin N, Platt R, Roblin DW, Lane K, Goodman M, Nelson WW, Yang X, Soumerai SB. A randomized trial of direct-to-patient communication to enhance adherence to beta-blocker therapy following myocardial infarction. Arch Intern Med. 2008;168(5):477-83. doi: 10.1001/archinternmed.2007.132

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