Skip to main content
Log in

Adherence and satisfaction with oral hypoglycemic medications: a pilot study in Palestine

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Objectives Diabetes mellitus is a chronic progressive disease characterized by numerous health complications. Medication adherence is an important determinant of therapeutic outcome. Few studies on medication adherence have been published from the Arab countries. Therefore, the objective of this pilot study was to assess hypoglycemic medication adherence and its association with treatment satisfaction. Setting Military Medical Services clinic in Nablus, Palestine. Methods This is a cross sectional descriptive study. A convenience sample of 131 diabetic patients was studied. The 8-item Morisky Medication Adherence Scale (MMAS-8) and Treatment Satisfaction Questionnaire for Medication were used to assess adherence and treatment satisfaction, respectively. Statistical Package for Social Sciences was used for statistical analysis. Main outcome measure Level of adherence, treatment satisfaction and association between adherence and treatment satisfaction among diabetic patients. Results According to MMAS-8, 50 patients (38.5%) had a high adherence, 58 (44.6%) had a medium adherence and 22 (16.9%) had a low adherence rate. The mean scores of satisfaction domains were 71 ± 17.6 and 95 ± 16.4 for effectiveness (EFF) and side effects (SE), respectively. Adherence score was a positively and significantly correlated with EFF satisfaction domain (P < 0.01) and age (P = 0.01). Similar significant correlation was found between adherence level and duration of illness (P = 0.047). However, adherence was not significantly associated with gender (P = 0.2), number of hypoglycemic medications (P = 0.5) or SE satisfaction domain (P = 0.2). Discussion and conclusion The majority of diabetic patients in this pilot study were non-adherent. Improving patients’ treatment satisfaction will improve treatment adherence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53.

    Article  PubMed  Google Scholar 

  2. Wens J, Vermeire E, Royen PV, Sabbe B, Denekens J. GPs’ perspectives of type 2 diabetes patients’ adherence to treatment: a qualitative analysis of barriers and solutions. BMC Fam Pract. 2005;6(1):20.

    Article  PubMed  Google Scholar 

  3. Breitscheidel L, Stamenitis S, Dippel FW, Schöffski O. Economic impact of compliance to treatment with antidiabetes medication in type 2 diabetes mellitus: a review paper. J Med Econ. 2010;13(1):8–15.

    Article  PubMed  CAS  Google Scholar 

  4. Ho PM, Rumsfeld JS, Masoudi FA, McClure DL, Plomondon ME, Steiner JF, Magid DJ. Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med. 2006;166(17):1836–41.

    Article  PubMed  Google Scholar 

  5. Khattab MS, Aboifotouh MA, Khan MY, Humaidi MA, Al-Kaldi YM. Compliance and control of diabetes in a family practice setting, Saudi Arabia. East Mediterr Health J. 1999;5(4):755–65.

    PubMed  CAS  Google Scholar 

  6. Sweileh W, Aker O, Hamooz S. Rate of compliance among patients with diabetes mellitus and hypertension. An-Najah Univ J Res (N Sci). 2005;19:1–11.

    Google Scholar 

  7. Shokair FN. Pattern and determinants of compliance of diabetics to health care in Alexandria. A community based study. Bull Alex Fac Med. 2010;34(1):200–10.

    Google Scholar 

  8. Shams M, Barakat E. Measuring the rate of therapeutic adherence among outpatients with T2DM in Egypt. Saudi Pharm J. 2010;18(4):225–32.

    Article  Google Scholar 

  9. Trinacty CM, Adams AS, Soumerai SB, Zhang F, Meigs JB, Piette JD, Ross-Degnan D. Racial differences in long-term adherence to oral antidiabetic drug therapy: a longitudinal cohort study. BMC Health Serv Res. 2009;9:24.

    Article  PubMed  Google Scholar 

  10. Biderman A, Noff E, Harris SB, Friedman N, Levy A. Treatment satisfaction of diabetic patients: what are the contributing factors? Fam Pract. 2009;26(2):102–8. Epub 2009 Mar 2.

    Article  PubMed  Google Scholar 

  11. Nozaki T, Morita C, Matsubayashi S, Ishido K, Yokoyama H, Kawai K, Matsumoto M, Takii M, Kubo C. Relation between psychosocial variables and the glycemic control of patients with type 2 diabetes: a cross-sectional and prospective study. Biopsychosoc Med. 2009;3(1):4.

    Article  PubMed  Google Scholar 

  12. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487–97.

    Article  PubMed  CAS  Google Scholar 

  13. George CF, Peveler RC, Heiliger S, Thompson C. Compliance with tricyclic antidepressants: the value of four different methods of assessment. Br J Clin Pharmacol. 2000;50:166–71.

    Article  PubMed  CAS  Google Scholar 

  14. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008;10:348–54.

    Article  Google Scholar 

  15. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67–74.

    Article  PubMed  CAS  Google Scholar 

  16. Bharmal M, Payne K, Atkinson MJ, Desrosiers MP, Morisky DE, Gemmen E. Validation of an abbreviated treatment satisfaction questionnaire for medication (TSQM-9) among patients on antihypertensive medications. Health Qual Life Outcomes. 2009;7:36.

    Article  PubMed  Google Scholar 

  17. Atkinson MJ, Kumar R, Cappelleri JC, Hass SL. Hierarchical construct validity of the treatment satisfaction questionnaire for medication (TSQM version II) among outpatient pharmacy consumers. Value Health. 2005;8(Suppl 1):S9–24.

    Article  PubMed  Google Scholar 

  18. Atkinson MJ, Sinha A, Hass SL, et al. Validation of a general measure of treatment satisfaction, the treatment satisfaction questionnaire for medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes. 2004;2:12.

    Article  PubMed  Google Scholar 

  19. Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27(5):1218–24.

    Article  PubMed  Google Scholar 

  20. Melikian C, White TJ, Vanderplas A, Dezii CM, Chang E. Adherence to oral antidiabetic therapy in a managed care organization: a comparison of monotherapy, combination therapy, and fixed-dose combination therapy. Clin Ther. 2002;24(3):460–7.

    Article  PubMed  Google Scholar 

  21. Adisa R, Alutundu MB, Fakeye TO. Factors contributing to nonadherence to oral hypoglycemic medications among ambulatory type 2 diabetes patients in southwestern Nigeria. Pharm Pract (Internet). 2009;7(3):163–9.

    Google Scholar 

  22. Morello CM, Chynoweth M, Kim H, Singh RF, Hirsch JD. Strategies to improve medication adherence reported by diabetes patients and caregivers: results of a taking control of your diabetes survey (February). Ann Pharmacother. 2011;45(2):145–53.

    Google Scholar 

  23. Redekop WK, Koopmanschap MA, Stolk RP, Rutten GE, Wolffenbuttel BH, Niessen LW. Health-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes. Diabetes Care. 2002;25(3):458–63.

    Article  PubMed  Google Scholar 

  24. Hasio LD, Salmon JW. Predicting adherence to prescription medication purchase among HMO enrollees with diabetes. J Manag Care Pharm. 1999;5(4):336–41.

    Google Scholar 

  25. Nicolucci A, Cucinotta D, Squatrito S, Lapolla A, Musacchio N, Leotta S, Vitali L, Bulotta A, Nicoziani P, Coronel G, QuoLITy Study Group. Clinical and socio-economic correlates of quality of life and treatment satisfaction in patients with type 2 diabetes. Nutr Metab Cardiovasc Dis. 2009;19(1):45–53.

    Article  PubMed  CAS  Google Scholar 

  26. Pollack MF, Purayidathil FW, Bolge SC, Williams SA. Patient-reported tolerability issues with oral antidiabetic agents: associations with adherence; treatment satisfaction and health-related quality of life. Diabetes Res Clin Pract. 2010;87(2):204–10.

    Article  PubMed  CAS  Google Scholar 

  27. Bolen S, Feldman L, Vassy J, Wilson L, Yeh H-C, Marinopoulos S, et al. Systematic review: comparative effectiveness and safety of oral medications for type 2 diabetes mellitus. Ann Intern Med. 2007;147(6):386–99.

    PubMed  Google Scholar 

  28. Asche CV, McAdam-Marx C, Shane-McWhorter L, Sheng X, Plauschinat CV. Association between oral antidiabetic use, adverse events and outcomes in patients with type 2 diabetes. Diab Obes Metab. 2008;10(8):638–45.

    Article  CAS  Google Scholar 

  29. Cramer J. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27:1218–24.

    Article  PubMed  Google Scholar 

  30. Grant RW, Devita NG, Singer DE, Meigs JB. Polypharmacy and medication adherence in patients with type 2 diabetes. Diabetes Care. 2003;26:1408–12.

    Article  PubMed  Google Scholar 

  31. Brownlee-Duffeck M, Peterson L, Simonds JF, Goldstein D, Kilo C, Hoette S. The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus. J Consult Clin Psychol. 1987;55:139–44.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Authors would like to acknowledge Military Medical Services in Palestine for their approval and support to carry on the project.

Funding

None.

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Waleed M. Sweileh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jamous, R.M., Sweileh, W.M., Abu-Taha, A.S. et al. Adherence and satisfaction with oral hypoglycemic medications: a pilot study in Palestine. Int J Clin Pharm 33, 942–948 (2011). https://doi.org/10.1007/s11096-011-9561-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-011-9561-7

Keywords

Navigation