Background: Diabetes is increasing globally resulting in 1.5 million deaths in 2012. The high mortality is due to life-threatening complications of uncontrolled sugar. Medication helps to control glucose level and prevents its complications.

Objective: To identify the factors associated with medication adherence among type 2 diabetes mellitus (DM) patients.

Methods: A hospital based cross sectional study was conducted among 343 patients visiting Dhulikhel Hospital, Nepal for their regular Fasting Blood Sugar test from September to December 2016. Inclusion criteria were (i) type 2 DM patients (ii) under diabetes medication from at least past three months (iii) aged 18 years or above. We measured medication adherence using Nepali version of 8 item Morisky Medication Adherence Scale (MMAS-8) (© 2007 Donald E. Morisky). Adherence was categorized as high if MMAS score was equal to 8 and moderate/low if it was less than 8. We used standard questionnaire to measure socio-demographic and clinical factors. Multivariate logistic regression was applied to assess factors associated with medication adherence.

Results: Proportion of high and moderate/low medication adherence among the respondents were 60.9% and 39.1% respectively. In multivariate logistic regression, high medication adherence was found to be positively associated with formal education [AOR: 2.43 (95% CI: 1.34, 4.39), p=0.003] and attendance of diabetes counseling [AOR: 1.76 (95% CI: 1.02, 3.04), p=0.04] after adjusting for age, occupation, annual household per-capita income, medicine intake duration and diabetes medicine types. Other variables in the model were not statistically significantly associated.

Conclusion: Formal education and attendance of diabetes counseling were found to positively affect patients’ adherence to medicine. We encourage heath care institutions to provide counseling services to all type 2 DM patients and focus more on those who are least educated.


P. Shakya: None. B.M. Karmacharya: None. A. Shrestha: None. B.E. Kulseng: None.

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