Prospective study of factors affecting medication adherence in diabetes mellitus patients

Navneet Agrawal, Dharmendra Tiwari


Background: Treatment interruption is an obstacle in therapeutic control of diabetes mellitus. Treatment interruption leads to uncontrolled hyperglycemia which increases the risk of diabetes related complications. Aim of study the factors responsible for the treatment interruptions among the diabetes patients.

Methods: Four hundred and ninety-one diabetes patients were studied at Diabetes, obesity and Thyroid center, Gwalior between September 2018 to December 2018. Responses were recorded using a detailed questionnaire consisting of 25 questions. Responses were recorded in terms of Yes or No along with the basic demographic details.   

Results: Male preponderance was reported (68.4%). Majority were off the diabetes treatment for last 1-5 months (78.8%). Most common response for the treatment interruption was long life medication period (73.7%) followed by the fact that majority were not aware of the consequences of missing the doses (68%), 66.6% due to the side effect of the medication and 57.8% had financial problem.

Conclusions: Large number of diabetes patients had poor adherence. There are many modifiable factors which can be improved on individual basis to improve the glycemic outcomes.


Diabetes complications, Diabetes mellitus, Modifiable risk factors, Side effects

Full Text:



World Health Organization. Adherence to long term therapies, time for action. Geneva: World Health Organization 2003: 221. Available at:;jsessionid=71115FB1185B3776921EDD7E4774742A?sequence=1. Accessed 16 April 2020.

Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care 2004;27(5):1218-24.

Sokol MC, Mc Guigan KA, Verbrugge RR, Epstein RS. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care. 2005;43:521-30.

Lee WC, Balu S, Cobden D, Joshi AV, Pashos CL. Prevalence and economic consequences of medication adherence in diabetes: a systematic literature review. Manag Care Interface. 2006;19(7):31-41.

Di Matteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42:200-9.

Van Bruggen R, Gorter K, Stolk RP, Zuithoff P, Klungel OH et al. Refill adherence and polypharmacy among patients with type 2 diabetes in general practice. Pharmacoepidemiol Drug Saf. 2009;18(11):983-91.

Pollack MF, Purayidathil FW, Bolge SC, Williams SA. Patient-reported tolerability issues with oral antidiabetic agents: Associations with adherence; treatment satisfaction and health-related quality of life. Diabetes Res Clin Pract. 2010;87(2):204-10.

Ascher-Svanum H, Lage MJ, Perez-Nieves M, Reaney MD, Lorraine J, Rodriguez A et al. Early Discontinuation and Restart of Insulin in the Treatment of Type 2 Diabetes Mellitus. Diabetes Ther. 2014;5(1):225-42.

Awodele O, Osuolale JA. Medication adherence in type 2 diabetes patients: study of patients in Alimosho General Hospital, Igando, Lagos, Nigeria. African Health Sciences. 2015;15(2):513-22.

Mojtabai R, Olfson M. Medication Costs, Adherence and Health Outcomes Among Medicare Beneficiaries. Health Aff. 2003;22(4):220-9.

Tiv M, Viel J-F, Mauny F, Eschwe`ge E, Weill A, et al. Medication Adherence in Type 2 Diabetes: The ENTRED Study 2007, a French Population- Based Study. PLoS One. 2012:7(3):e32412.

Lawton J, Peel E, Parry O, Douglas M. Patients’ perceptions and experiences of taking oral glucose-lowering agents: a longitudinal qualitative study. Diabet Med. 2008;25(4):491-5.

Mosnier-Pudar H, Hochberg G, Eschwege E, Virally ML, Halimi S et al. How do patients with type 2 diabetes perceive their disease? Insights from the French diabasis survey. Diabetes Metab. 2009;35(3):220-7.

Cegala DJ, Marinelli T, Post D. The effects of patient communication skills training on compliance. Arch Fam Med. 2000;9(1):57-64.

Magadza C, Radloff SE, Srinivas SC. The effect of an educational intervention on patients’ knowledge about hypertension, beliefs about medicines, and adherence. Res Social Adm Pharm. 2009;5(4):363-75.

Garber MC, Nau DP, Erickson SR, Aikens JE, Lawrence JB. The concordance of self-report with other measures of medication adherence: a summary of the literature. Med Care. 2004;42:649-52.