Evaluation of the Beliefs about Medication, Adherence and Self-Care Knowledge among Type 2 Diabetic Patients in a Nigerian Teaching Hospital

Abstract

Objective: This study was carried to evaluate the beliefs about medicines, adherence and self care management knowledge among type 2 diabetes mellitus patients in a teaching hospital in south eastern Nigeria.

Method: A questionnaire consisting of standardized survey instruments (DSCK–30, MMAS, BMQ and factors affecting knowledge acquisition and barriers to adherence) were used for this study. The questionnaire was interviewer assisted and administered to a cross section of 480 randomly selected ambulatory adult patients (18 years and above) who were attending the endocrinology clinic in the teaching hospital used for this study. Data was presented in frequency tables. Bivariate analysis was used to test the correlations among variables. Chi - square test was used to test for independence of variables.

Results: 413 participated in the study. The bivariate analysis showed a correlation between patients knowledge of diabetes and adherence (0.776, P = 0.000). Chi Square tests showed an association between occupation and monthly income with the categorical adherence of the patients. No association was found between age, gender, family history, duration of diabetes with categorical adherence for this study. The overall adherence of the patients on the Morisky Medication Adherence Scale (MMAS) was 6.2. Most of the respondents reported side effects (75.3%), forgetfulness (79%), cost of medications (84%), polypharmacy/pillburden (72.4%) and depression 77.0% as major barriers to adherence to their medications. Most of the respondents reported lack of time on the part of the patients, lack of time on the part of the health care professionals and access to health care as major barriers to acquiring diabetes care knowledge.

Conclusion: There are many factors that lead to medication non- adherence and acquisition of diabetes self care knowledge. Cost of medications, forgetfulness, polypharmacy, depression and side effects were the major factors reported in this study. A lot of work should be done in this area to improve patients’ adherence to medications for better prognostic outcomes.