Factors contributing to non-adherence to diabetics treatment among patients attending clinics in Mwanza city, Tanzania

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