Factors Associated with Non-adherence to Oral Hypoglycemic Medications among Adult Type 2 Diabetes Mellitus outpatients attending Mbagathi District Hospital Nairobi, Kenya

Abstract

Non-adherence to diabetic medication has been shown to contribute to poor glycemic control leading to development of complications. Given that patients’ adherence to prescribed oral diabetic medication assessment is rare in routine clinical practice, the study aimed at determining the factors associated with non-adherence to oral diabetic medication among adult type 2 diabetes mellitus outpatients at Mbagathi Hospital. A descriptive cross-sectional study was carried out after getting administrative clearance from the hospital medical superintendent and ethical approval from KEMRI scientific and ethics committee. A systematic random sampling method was used to recruit study participants and informed consent was obtained. Data was collected using pretested semi structured questionnaire and key informant interviews. Pearson’s chi square (X2) was used to assess the association between dependent and independent categorical variables and binary logistic regression for independent association. Factors associated with non-adherence to oral hypoglycemic agents were considered statistically significant at P ≤ 0.05. Among the 113 study participants recruited 61.9% were females and their mean age was 53.4 ±11 years. The prevalence of non-adherence to oral diabetic medication(s) was 45.1%. Twenty-seven percent of the study participants had at least one perception that hindered them from adhering to their oral diabetic medication(s). Non-adherence was significantly associated with taking two or more types of oral diabetic medication(s) (AOR = 6.51; 95% CI: 1.63 -25.03; P < 0.006) and forgetfulness (AOR = 3.12; 95% CI: 1.26 – 7.73 P < 0.014). Non-adherence to oral hypoglycemic agents among type 2 diabetic outpatients at Mbagathi Hospital is associated with use of multiple oral diabetic medications and forgetfulness. Treatment should be simplified and health education enhanced in the area of diabetic medication adherence. In addition, ways should be devised for reminding patients to take their diabetic medications.