article · Saudi Pharmaceutical Journal
Achieving metabolic control in type 2 diabetes relies heavily on consistent adherence to treatment. An assessment of 226 outpatients with type 2 diabetes at Mansoura University in Egypt revealed suboptimal adherence rates across medications, diet and exercise, and clinic appointments. Multiple influences govern patient compliance with prescribed oral hypoglycaemic drugs. Key social factors include marital status, family support, and socio-economic standing. Adherence is also shaped by patient-specific variables, including knowledge of the disease, beliefs and motivation regarding medication, and the regularity of blood glucose self-monitoring. Regimen characteristics further dictate compliance: complex schedules, multiple prescribed drugs, and adverse side effects correlate with poorer adherence. Finally, economic challenges, specifically direct and indirect care costs relative to income, substantially decrease compliance rates. Enhancing adherence requires ongoing patient education, reduced medication costs, and an expanded role for pharmacists in chronic disease support.
Poor adherence to diabetes treatments prevents satisfactory blood glucose control, which can accelerate the onset of severe complications and raise mortality rates. Identifying the exact social, personal, economic, and pharmacological barriers that hinder compliance helps healthcare systems design better support programmes, simplify prescribing practices, and reduce unnecessary treatment costs for vulnerable individuals managing long-term conditions.
The findings can inform pharmaceutical companies, digital health developers, and healthcare providers seeking to design tailored adherence programmes, simplified drug regimens, or patient education services. These insights could guide the creation of pharmacist-led medication management services or affordable combination therapies. Because the study represents observational clinical research, any resulting commercial service models or intervention tools would require further development and practical testing in real-world healthcare settings.
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BACKGROUND AND OBJECTIVE: The promotion of therapeutic adherence is considered as an integral component of pharmaceutical care practice and patient healthcare. It has been shown that despite effective methods of treatment, 50% of diabetic patients fail to achieve satisfactory glycemic control, which leads to accelerated development of complications and increased mortality. Clinical experience indicates that no improvement of metabolic control is possible without patients' adherence to medications. This study sought to examine the rate of medication adherence and different factors affecting it among Type 2 diabetic patients in Egypt. METHODS: A total of 226 Type 2 diabetic patients who fulfilled the inclusion criteria were recruited in the current study. Adherence to the treatment was evaluated during patients' hospitalization in the Outpatient Clinics of Internal Medicine Department at University of Mansoura, Egypt. The medication adherence has been assessed during a personal interview with each patient using a multiple-choice graded questionnaire. RESULTS: In the study population, the adherence rates to medication, dietary/exercise and appointment were observed to be suboptimal. The most important social factors that were significantly affecting adherence rate to the prescribed oral hypoglycemic agent(s) included marital status (P < 0.01), family support (P < 0.01), and socio-economical level (P < 0.01). Other patient factors that were significantly affecting therapeutic adherence were patient knowledge about the disease (P < 0.01), patients' beliefs and motivation about prescribed drugs (P < 0.01), and regularity of patients' self monitoring of blood glucose level (P < 0.01). Among drug factors which found to affect significantly the rate of medication adherence are the number of drugs taken (P < 0.05), complexity of drug regimen (P < 0.01), and the presence of drug side effects (P < 0.01). Economical factor played an equally important role. Direct and indirect care costs in relation to patients' income were significantly affecting the rate of adherence to medication (P < 0.01). CONCLUSIONS: An improvement with the adherence to oral hypoglycemic agent(s) may be achieved through continuing patient education about diabetes, improvement of patients' economical levels as well as a reduction in the cost of medication. Pharmaceutical companies have to be involved and pharmacists have to be payed for helping chronically ill patients to take their medicines correctly for improving clinical outcomes.
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DOI: 10.1016/j.jsps.2010.07.004
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