Ephrem Mebrahtu Araya1, Haylay Araya Gebrezgabiher1, Gebretsadkan Hintsa Tekulu2, Niguse Meles Alema1, Desalegn Getnet1, Hirut Teame Gebru3, Betelhem Anteneh Adamu4. 1. Department of Pharmacy, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia. 2. Department of Pharmacognosy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. 3. Department of Public Health, Colleges of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia. 4. Department of Pharmacognosy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Abstract
INTRODUCTION: Medication non-adherence is a major public health problem among diabetes mellitus patients. However, there is a lack of data regarding its magnitude and the factors contributing to Ethiopia's non-adherence, especially in the Tigrai region. This study was conducted to assess the magnitude of non-adherence and its contributing factors among diabetes mellitus patients in the Eastern Zone of Tigrai, Northern Ethiopia. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted at Adigrat and Wukro General Hospitals using a pre-tested, self-administered, semi-structured questionnaire developed from the relevant literature and a checklist developed to review patient medical cards for the period of the 15th of March to the 15th of July, 2019. Data were analyzed using Statistical Package for Social Sciences version 20. Association between the dependent and the independent variable was performed using logistic regression and a p-value of <0.05 was considered significant. RESULTS: From a total of 321 study participants, 63.9% of the patients were non-adherent to their medications. Two-month dose issued on each visit (AOR = 2.865, 95% CI 1.380-5.949), dose issued for more than three months (AOR = 4.314, 95% CI 1.526-12.195), monthly income below 500 birr (AOR = 5.048, 95% CI 2.094-12.168), monthly income between 500 and 2000 birr (AOR = 2.593, 95% CI 1.032-6.517), distance greater than 24 kilometers from hospital to home (AOR = 10.091, 95% CI 3.509-29.020), more than four prescribed medications per visit (AOR=7.192, 95% CI= 2.171-23.824), never receiving counseling (AOR=22.334, 95% CI= 9.270-53.810), and diabetes-related admission (AOR=0.248, 95% CI= 0.078-0.789) were significantly associated with patients' non-adherence to diabetes mellitus medications. CONCLUSION: The level of diabetic medication adherence was suboptimal, and our study highlights that better monthly earning, nearby health-care accessibility, fewer prescribed medication, and getting appropriate counseling about diabetes mellitus were predictive of adherence to medications. Hence, an urgent intervention targeting the development of guidelines that involve these determinates should be employed to improve health care.
INTRODUCTION: Medication non-adherence is a major public health problem among diabetes mellitus patients. However, there is a lack of data regarding its magnitude and the factors contributing to Ethiopia's non-adherence, especially in the Tigrai region. This study was conducted to assess the magnitude of non-adherence and its contributing factors among diabetes mellitus patients in the Eastern Zone of Tigrai, Northern Ethiopia. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted at Adigrat and Wukro General Hospitals using a pre-tested, self-administered, semi-structured questionnaire developed from the relevant literature and a checklist developed to review patient medical cards for the period of the 15th of March to the 15th of July, 2019. Data were analyzed using Statistical Package for Social Sciences version 20. Association between the dependent and the independent variable was performed using logistic regression and a p-value of <0.05 was considered significant. RESULTS: From a total of 321 study participants, 63.9% of the patients were non-adherent to their medications. Two-month dose issued on each visit (AOR = 2.865, 95% CI 1.380-5.949), dose issued for more than three months (AOR = 4.314, 95% CI 1.526-12.195), monthly income below 500 birr (AOR = 5.048, 95% CI 2.094-12.168), monthly income between 500 and 2000 birr (AOR = 2.593, 95% CI 1.032-6.517), distance greater than 24 kilometers from hospital to home (AOR = 10.091, 95% CI 3.509-29.020), more than four prescribed medications per visit (AOR=7.192, 95% CI= 2.171-23.824), never receiving counseling (AOR=22.334, 95% CI= 9.270-53.810), and diabetes-related admission (AOR=0.248, 95% CI= 0.078-0.789) were significantly associated with patients' non-adherence to diabetes mellitus medications. CONCLUSION: The level of diabetic medication adherence was suboptimal, and our study highlights that better monthly earning, nearby health-care accessibility, fewer prescribed medication, and getting appropriate counseling about diabetes mellitus were predictive of adherence to medications. Hence, an urgent intervention targeting the development of guidelines that involve these determinates should be employed to improve health care.