Barriers to Medications Adherence among Uncontrolled Type 2 Diabetic Patients in PHCs, Riyadh, Saudi Arabia

Abstract

Introduction: Diabetes Mellitus is one of the most common metabolic problems in Saudi Arabia and its chronic progressive disease is characterized by numerous health complications. Diabetes is a growing medical problem and the costs to society are great and rising. The recent report formed by International Diabetes Federation Diabetes Atlas values that there are presently 387 million people alive with diabetes globally in 2014, a 105% rise from its last report in 2011 with the highest number of people living in the western pacific. A recent systematic analysis study on global load disease analyzed data from health examination surveys and epidemiological studies involving data from 2.7 million participants and 370 country-years reports that a total of 347 million adults are alive with diabetes worldwide. Aim: This study aimed to improve health services provided to Diabetic patients and identify the barriers to medication adherence in those who attend Wazarat health center, chronic illness clinics. Methods: A descriptive, observation retrospective case-control study enrolled 162 patients with type 2 diabetes aged 35 years and above at Prince Sultan Military Medical City (PSMMC), Wazarat Health Center, Riyadh, KSA within two years (Year 2020-2021). Using a probability stratified sampling method, we recruited patients who were able to provide a consent form, following up in chronic illness clinics and received treatment for at least 3 months and actively filled prescriptions for medications related to a chronic disease were subjects of this study. The sample was collected from chronic illness clinics, in which where the majority of patients were uncontrolled type 2 diabetes due to the COVID-19 pandemic. The target HbA1C is 7%. Results: The prevalence of poor glycemic control was 67.9% and the prevalence of poor glycemic control was significantly higher among females (p=0.031), those who have blood glucose devices at home (p=0.032), those who regularly monitored blood glucose levels (p=0.001) and those with a regular visit to DM clinic (p=0.001). The most common barrier to medication was fear of side effects (20.4%) and taking too many drugs (19.1%). Non-adherence to medication was significantly more common among those with uncontrolled HbA1c (p=0.022), those who did not receive education about medication side effects (p=0.010), and those who were non-adherence to diet and exercise (p=0.001). Conclusion: More than one-third of the diabetic population was non-adherence to diabetic medication. Patients with poor glycemic control who did not receive education about medication side effects and who were non-compliance with diet and exercise were more likely to be non-adherent to Diabetes mellitus medication.