Abstract:
Background: Non-adherence in chronic diseases has been described earlier as taking
less than 80% of the prescribed treatment. Non-adherence to the diabetes treatment
regimen is possibly the most common reason for poor health outcomes among people
with diabetes. The rates of non-adherence to diabetes regimen tasks are highly variable,
but have significant consequences on diabetes outcomes and the effectiveness of
treatments. Non-adherence is a problem that has many contributing factors and the
responsibility for adherence must be shared by health professionals, the health care
system, the community and the patients.
Objective: The aim of this study was to determine the proportion (magnitude) of non-
adherence and its contributing factors among diabetic patients attending clinics in
Mwanza city. Specifically the study determined the relationship between non-adherence
and various variables which are; alcohol use, knowledge on diabetes, its treatment and
complication, travel distance to reach the clinic by patients and medication side effects.
Results: A total of 272 diabetic patients attending two diabetes clinics in Mwanza city
were interviewed. Of the respondents, 118(43.4%) were males. Their mean age was
51.22 (14.97 standard deviation).
Among all respondents, 255 (93.8%) scored High level of knowledge on Diabetes and
its treatment as compared with those with low knowledge making it not a significant
contributor to non-adherence. Of the 272 patients, 77(28.3%) reported non-adherent.
v
Alcohol use, medication side effects and distance travelled to reach the clinic were the
significant contributors to non-adherence (p=O.OOl).
Conclusion: Factors which were found contributing to non-adherence to diabetes
treatment include: alcohol use, medication side effects and few clinics located far from
most of patient. Quality improvement efforts should focus on these modifiable factors.
It is therefore recommended that, patients should be educated on the possible side effects
that can occur during treatment and that they should not stop taking the drugs against
medical advice. Alcohol use should be discouraged among diabetic patients as it is the
cause of non-adherence probably due to forgetfulness. This should be done at all levels
from the doctors, nurses and drug dispensers in all clinics. Also more diabetes clinics
should be established at least in each district hospital in order to improve accessibility to
clinics and reduce long waiting time.
For improving adherence, availability of information with patients' perspectives about
patients' expectations, needs and experiences in taking medication and about what might
help them to become and remain adherent should be maintained.
Key terms: - Diabetes; type 1 diabetes; type 2 diabetes; Medication; Non-adherence
