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Abstract

POOR ADHERENCE TO ANTIDIABETIC MEDICATIONS IN PATIENTS WITH DIABETES AT MADINA, SAUDI ARABIA: THE ROLL OF DIABETES RELATED EMOTIONAL DISTRESS

Kenana Owaidah*, Abrar Al-Harbi, Arwa Al-Hujaili, Nehal Al-Oufi and Eman Alfadhli

ABSTRACT

Background: Diabetes mellitus is a chronic disease that significantly grows globally. It is a major cause of mortality and morbidity and so, excellent control for diabetes by medication is strictly advised. Patients may have terrible adherence to drugs, and sometimes they do not take their medication. Several factors affect the adherence of diabetic patients. Distress among diabetic patients was reported, and it negatively impact on the patient's life. Objective: To determine the prevalence of diabetes related emotional distress in patients with diabetes at Madina, Saudi Arabia, assess their adherence to antidiabetic medications, and to examine the influence of diabetes related emotional distress on adherence to the antidiabetic medications. Material and methods: This is a cross sectional study conducted in Madina, Saudi Arabia between November 2016 and April 2017. Patients with diabetes were recruited from Prince Majed bin Abdul-Aziz Diabetes Center and two primary care centers. Inclusion criteria include patients 14 years and older with type 1 or type 2 diabetes mellitus. Exclusion criteria include patients with gestational diabetes and patients with mental retardation or Alzheimer disease. The study was approved by the research and human ethics committee of Taibah University. After taking patients 'consents, data was collected through interviews using a questionnaire that consists of 3 parts: first, demographic data which includes age, type of DM, duration of DM, number and type of hypoglycaemic medications and the presence of diabetic complications. Second, problem areas in diabetes (PAID) questionnaire which was used to assess for diabetes-related emotional distress and third, the eight-item Morisky Medication Adherence Scale (MMAS) which was used to assess for adherence to hypoglycemic medications. On the same day of the interviews, medical records were reviewed for most recent hemoglobin A1C (HbA1c) levels. Results: A total of 403patients were included in the study. Approximately 60% of the patients were men. The mean age of the study population was 48.17±15.01years (14–88 years). Most of the participants were Saudi 343(85.1%) More than two thirds of the patients were having T2DM 252 (62.5%) and 87 (21.6%) were having T1DM. The mean HbA1c was 8.05±1.68, and the mean duration of diabetes was 12.37±8.81. In the present study, we found 30.3% of the patients were having diabetes related emotional distress and 65.8% were having poor adherence to the diabetes medications. 32.2% had medium adherence, 2% patients had high adherence. Diabetes related emotional distress was significantly associated with poor adherence, P 0.001. Factors contributing to the increased risk of diabetes related emotional distress were duration of diabetes. Factors contributing to the increased risk of poor adherence to antidiabetic medications were: emotion stress (P 0.001), male sex. Conclusions: Our study demonstrated a substantial poor antidiabetic medications adherence in patients with diabetes at Madina, Saudi Arabia. There was a significant relationship between diabetes related emotional distress and non-adherence. even though The distress was low in prevalence among patients. This stresses the need for continuous education and motivation to patients with diabetes at follow up visits. Early screening for diabetes related emotional stress in patients with poor drug adherence is recommended.

Keywords: Compliance, Depression, Diabetes, Distress, Medication adherence, MMAS.


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