Characteristics of patients with type 2 diabetes mellitus with different levels of adherence to pharmacotherapy

Abstract

Research indicates that the issue of adherence is multifactorial in nature and requires a comprehensive assessment within each specific patient population since the structure of the determinants may vary significantly depending on the socio-economic context, access to healthcare and the specific organization of the healthcare system in different countries. Aim. To assess the level of adherence to pharmacotherapy among patients with type 2 diabetes mellitus and identify the main clinical, demographic and socio-psychological factors that affect it in order to inform strategies for improving the effectiveness of the drug treatment for this patient group. Materials and methods. A single-center cohort study was conducted; it involved 120 patients with a confirmed diagnosis of type 2 diabetes who were under outpatient care and received hypoglycemic pharmacotherapy. To assess the structure of pharmacotherapy, the main groups of hypoglycemic agents were taken into account. The level of adherence to pharmacotherapy was determined using the validated Medication Adherence Report Scale questionnaire. Results and discussion. The study cohort was predominantly comprised of older patients, both men and women, with a long-standing history of type 2 diabetes and a high prevalence of comorbid conditions. Almost half of the patients were taking five or more medicines per day, creating conditions for polypharmacy and reduced adherence to treatment. The most commonly used medicines were metformin, statins and antihypertensive drugs. A significant proportion of the patients examined received the combination therapy, which was due to the presence of obesity, hypertension, dyslipidaemia and other comorbidities. Conclusions. In patients with type 2 diabetes mellitus, an insufficient level of adherence to pharmacotherapy was observed (32.0 % – high, 38.8 % – moderate and 29.2 % – low levels). Low adherence to pharmacotherapy was significantly associated with older age (64.3 ± 4.8 years), longer duration of the disease (11.3 ± 6.0 years), polypharmacy (≥ 5 medicines per day) and complex medication regimens.