Abstract:
Background: Diabetes Mellitus (DM) is a common chronic noncommunicable disease with
increasing prevalence leading to serious complications. Effective management of DM depends
on the use of appropriate medications and the patients' adherence to the prescribed medication
regimen.
Objectives: To assess medication adherence, medication appropriateness, and the impact of
sociodemographic factors on medication adherence in patients receiving insulin therapy for
diabetes management
Methods: A cross-sectional observational study was conducted among the patients receiving
insulin therapy for the management of DM in the Diabetes and Endocrinology Unit of National
Hospital Kandy, Sri Lanka. Eligible patients were selected using a simple randomization method
and recruited after obtaining written and verbal consent. A complete medication history was
obtained to assess their medication adherence using the Brief Medication Questionnaire (BMQ).
Patients were categorized into four adherence groups based on their score for each screen in
BMQ. The relationship between sociodemographic factors and medication adherence was
evaluated. Appropriateness of the clinic medication list was assessed using the Medication
Appropriateness Index (MAI).
Results: A total of 385 patients were recruited. The mean±SD BMQ score was 1.24±1.05, and
optimal adherence was defined as a BMQ score of zero. Most of the patients were probable poor
adherents (n=168, 43.6%), followed by probable adherents (n=103, 26.8%), poor adherents
(n=79, 20.5%) and complete adherents (n=35, 9.1%). Medication adherence was significantly
influenced by the age (p<0.001), marital status (p<0.001), and education level (p<0.001). The
mean±SD MAI score was 0.28±0.23.
Conclusions: Medication adherence was sub-optimal among most participants and was impacted
by some sociodemographic features. The clinic medication list showed considerable
appropriateness. However, it can be further improved to be ideal according to current treatment
guidelines. These findings highlight the need to assess medication adherence and medication
appropriateness to enhance patient care and therapeutic outcomes.
