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Factors related to barriers and medication adherence in patients with type 2 diabetes mellitus: a cross-sectional study

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Abstract

Purpose

Evidence has shown that 50% of patients, including type 2 diabetes mellitus (DM), are non-adherent to the prescribed antidiabetic medication regimen. Some barriers lead to nonadherence in people with DM type 2. The study aimed to identify factors related to adherence in patient with DM and to assess the correlation between barriers to adherence type 2 DM patients.

Methods

The cross-sectional study was conducted in 63 primary healthcare centers in Surabaya, Indonesia. Patients with DM type 2 were recruited between April and September 2019 using convenient sampling technique. Ethics approval was obtained (80/EA/KEPK/2019).

Results

A total of 266 patients with type 2 DM participated in this study. Of the respondents, 201 (75.2%) were female. Unwanted drug effects, changes in medication regimens, and refilling the prescription when the drugs run out were most reported factors that affected adherence. Spearman correlations and linear regression tests were used to examine the relationship between barriers to medication adherence, and education with medication adherence. A significant difference was observed between the level of education and adherence (p = 0.031). The results showed an association between barriers to medication and adherence to medication (r = 0.304; p < 0.001) which was confirmed in regression analysis (R = 0.309, R square = 0.095, p <0.001).

Conclusions

Barriers to adherence are common and affect adherence to therapy. It is essential to expand the roles of health care professionals in the community to include counseling, barrier-monitoring, education, and problem-solving to improve patient medication adherence.

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All data generated or analyzed in this study are included in this article.

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Acknowledgements

The authors would like to thank the Faculty of Pharmacy, Universitas Airlangga, and the Lembaga Penelitian dan Pengabdian Masyarakat (LPPM) Universitas Airlangga for the support and facilities provided during the study. We also thank the research assistants involved in this study: Ms. Yenni Desilia Indahsari, Ms. Edlia Fadilah and Ms. Yerlita El Girath.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Indonesian Ministry of Education and Culture [DRPM – PDUPT 2019-2021]. The funder had no role in the study design; in the collection, and analysis or interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

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Authors and Affiliations

  1. Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Jl. Dr Ir Haji Soekarno, Mulyorejo, Surabaya, 60115, Indonesia

    Elida Zairina, Gesnita Nugraheni, Arie Sulistyarini,  Mufarrihah & Catur Dian Setiawan

  2. Innovative Pharmacy Practice and Integrated Outcome Research (INACORE) Group, Universitas Airlangga, Surabaya, Indonesia

    Elida Zairina, Gesnita Nugraheni, Arie Sulistyarini,  Mufarrihah & Catur Dian Setiawan

  3. Center for Patient Safety Research, Universitas Airlangga, Surabaya, Indonesia

    Elida Zairina

  4. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Sunil Kripalani

  5. Bachelor of Pharmacy Study Program, Faculty of Pharmacy, Universitas Airlangga, Jl. Dr Ir Haji Soekarno, Mulyorejo, Surabaya, 60115, Indonesia

    Safira Indah Lestari

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  1. Elida Zairina
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  2. Gesnita Nugraheni
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Corresponding author

Correspondence to Elida Zairina.

Ethics declarations

Ethics approval

Informed consent was obtained from all participants in this study and all procedures were approved by the Human Research Ethics Committee of the Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia (approval number: 80/EA/KEPK/2019).

Research involving human participants

This study was approved by The Human Research Ethics Committee of Faculty of Public Health at Universitas Airlangga, Surabaya, Indonesia.

Informed consent

All participants provided written informed consent to participate in this study.

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The authors declare that there is no conflict of interest.

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Impact on practice statement

• Barriers to adherence exist in patients with type 2 diabetes mellitus in Indonesia.

• Socioeconomic factors and education level of these patients impacts adherence.

• The role of pharmacists in the community should be expanded to counter this issue.

• Changes in medication regimens and failure to refill medicine also impact adherence.

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Zairina, E., Nugraheni, G., Sulistyarini, A. et al. Factors related to barriers and medication adherence in patients with type 2 diabetes mellitus: a cross-sectional study. J Diabetes Metab Disord 21, 219–228 (2022). https://doi.org/10.1007/s40200-021-00961-6

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  • DOI: https://doi.org/10.1007/s40200-021-00961-6

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