Online first
Research paper
Published online: 2025-02-28

open access

Page views 154
Article views/downloads 94
Get Citation

Connect on Social Media

Connect on Social Media

Medication Adherence and Quality of Life Among Type 2 Diabetes Patients: A Cross-Sectional, Observational Study in an Eastern India Set Up

Samsuj Joha1, Amar Kumar Gupta1, Shatavisa Mukherjee2, Nikhil Era1

Abstract

Objective: This study aimed to assess medication adherence and its association with quality of life (QoL) in type 2 diabetes (T2D) patients. Materials and methods: This cross-sectional study included 374 T2D patients aged 18–75 years, receiving treatment for at least six months. Medication adherence was evaluated using the Medication Adherence Rating Scale (MARS), and QoL was assessed using the WHO-QoL-BREF instrument. Data were analyzed using descriptive statistics and multiple regression to identify predictors of adherence and QoL. Results: The study reports a mean age of 55.69 years, with a male preponderance (59.89%). Sixty-one per cent exhibited low adherence scores (MARS 0–5), with a mean adherence score of 6.98. Higher adherence was significantly associated with improved fasting plasma glucose and postprandial glucose levels, although HbA1c levels were similar across adherence groups. QoL scores were highest in the physical, psychological, and social domains for patients with better adherence. Multiple regression analysis identified adherence as an independent predictor of QoL (p < 0.05) after adjusting for sociodemographic and clinical variables. Conclusions: This study highlights the critical link between medication adherence and improved QoL in T2D patients. Interventions targeting adherence barriers, particularly in rural populations, can enhance glycemic outcomes and QoL, underscoring the importance of patient-centered strategies in diabetes care.

Article available in PDF format

View PDF Download PDF file

References

  1. Hameed I, Masoodi SR, Mir SA, et al. Type 2 diabetes mellitus: From a metabolic disorder to an inflammatory condition. World J Diabetes. 2015; 6(4): 598–612.
  2. Sugandh F, Chandio M, Raveena F, et al. Advances in the Management of Diabetes Mellitus: A Focus on Personalized Medicine. Cureus. 2023; 15(8): e43697.
  3. Williams JS, Walker RJ, Smalls BL, et al. Patient-Centered Care, Glycemic Control, Diabetes Self-Care, and Quality of Life in Adults with Type 2 Diabetes. Diabetes Technol Ther. 2016; 18(10): 644–649.
  4. Islam SM, Purnat TD, Phuong NT, et al. Non-communicable diseases (NCDs) in developing countries: a symposium report. Global Health. 2014; 10: 81.
  5. Saeedi P, Petersohn I, Salpea P, et al. IDF Diabetes Atlas Committee. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9 edition. Diabetes Res Clin Pract. 2019; 157: 107843.
  6. Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc. 2011; 86(4): 304–314.
  7. Kleinsinger F. The Unmet Challenge of Medication Nonadherence. Perm J. 2018; 22: 18–033.
  8. Kvarnström K, Westerholm A, Airaksinen M, et al. Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research. Pharmaceutics. 2021; 13(7).
  9. Balarajan Y, Selvaraj S, Subramanian SV. Health care and equity in India. Lancet. 2011; 377(9764): 505–515.
  10. Sherwani SI, Khan HA, Ekhzaimy A, et al. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights. 2016; 11: 95–104.
  11. Basu S, Garg S, Sharma N, et al. Adherence to self-care practices, glycemic status and influencing factors in diabetes patients in a tertiary care hospital in Delhi. World J Diabetes. 2018; 9(5): 72–79.
  12. King P, Peacock I, Donnelly R. The UK prospective diabetes study (UKPDS): clinical and therapeutic implications for type 2 diabetes. Br J Clin Pharmacol. 1999; 48(5): 643–648.
  13. Kassahun A, Gashe F, Mulisa E, et al. Nonadherence and factors affecting adherence of diabetic patients to anti-diabetic medication in Assela General Hospital, Oromia Region, Ethiopia. J Pharm Bioallied Sci. 2016; 8(2): 124–129.
  14. World Health Organization (1996) WHO-BREF: Introduction, administration, scoring and generic version of the assessment. 1996. Geneva: WHO. http://www.who.int/mental_health/media/en/76.pdf (14.12.2024).
  15. Ramachandran A, Snehalatha C, Kapur A, et al. Diabetes Epidemiology Study Group in India (DESI). High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia. 2001; 44(9): 1094–1101.
  16. Rajasekharan D, Kulkarni V, Unnikrishnan B, et al. Self-care activities among patients with diabetes attending a tertiary care hospital in mangalore karnataka, India. Ann Med Health Sci Res. 2015; 5(1): 59–64.
  17. Sasi ST, Kodali M, Burra KC, et al. Self Care Activities, Diabetic Distress and other Factors which Affected the Glycaemic Control in a Tertiary Care Teaching Hospital in South India. J Clin Diagn Res. 2013; 7(5): 857–860.
  18. García-Pérez LE, Alvarez M, Dilla T, et al. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther. 2013; 4(2): 175–194.
  19. Puvvada RK, Gupta S, Tang CY, et al. Factors affecting self-medication practices among people living with type 2 diabetes in India- A systematic review. Metabol Open. 2021; 9: 100073.
  20. Sharma MG, Popli H. Challenges for Lower-Middle-Income Countries in Achieving Universal Healthcare: An Indian Perspective. Cureus. 2023; 15(1): e33751.
  21. Mishra R, Sharma SK, Verma R, et al. Medication adherence and quality of life among type-2 diabetes mellitus patients in India. World J Diabetes. 2021; 12(10): 1740–1749.
  22. Weaver RR, Lemonde M, Payman N, et al. Health capabilities and diabetes self-management: the impact of economic, social, and cultural resources. Soc Sci Med. 2014; 102: 58–68.
  23. Gebremedhin T, Workicho A, Angaw DA. Health-related quality of life and its associated factors among adult patients with type II diabetes attending Mizan Tepi University Teaching Hospital, Southwest Ethiopia. BMJ Open Diabetes Res Care. 2019; 7(1): e000577.
  24. DeFronzo RA. Combination therapy with GLP-1 receptor agonist and SGLT2 inhibitor. Diabetes Obes Metab. 2017; 19(10): 1353–1362.
  25. Tolley A, Hassan R, Sanghera R, et al. Interventions to promote medication adherence for chronic diseases in India: a systematic review. Front Public Health. 2023; 11: 1194919.
  26. Shah D, Gajjar D, Kapadia D, et al. Prevalence of Patient Awareness and Compliance in T2D Patients in the Urban Ahmedabad Region: A Retrospective and Prospective Study. Clin Diabetol. 2024; 13(4): 200–207.