Self-reported adherence to glucose lowering medications at a tertiary hospital in Ibadan, Nigeria.

Apstrakt

Background:  The  effectiveness  of  drug  therapies, especially in chronic illnesses, is directly dependent on adherence. Despite high rates of treatment failures in  our  community,  drug  adherence  studies  and interventions are scarce. This study evaluated self- reported  adherence  in  patients  receiving  glucose- lowering  drugs  for  diabetes  and  related  this  to glycemic control.Methods:  A  cross-sectional  study  of  persons  with diabetes attending the endocrinology clinic of a tertiary hospital in southwest Nigeria. Participants’ adherence to therapy was assessed by self-reported adherence and  compared  to  Morisky  8  adherence  score (reference  score).  Fasting  plasma  glucose  and glycated hemoglobin levels were determined. Results: Average age of participants was 59.3 years, 92.2% had type 2 diabetes, the rest had type 1. The mean duration of diabetes was 7.9 ± 6.5 years. Fasting plasma glucose and glycated hemoglobin were below cut-off points (indicating good control) in 41.7% and 48.3%  respectively.  Self-reported  adherence  to medications was high, avearge, and low in 80.9%, 13.6%, and 5.5% respectively. Morisky 8 adherence scores for high, medium, and poor were 38.9%. 31.9% and 29.2% respectively. Mean plasma glucose and glycated hemoglobin were above reference glucose control  ranges  for  all  categories  of  adherence reported. There was no relationship between mean plasma glucose and glycated hemoglobin levels and adherence  scores.  Major  factors  that  negatively affected  adherence  were  financial  constraints, unavailability of medications, and busyness. Conclusion:  The proportion of patients with good glycaemic  control  was  below  50%.  Self-reported adherence  to  glucose-lowering  medications  was found not to correlate with glycemic control