Non Adherence To Management Regimen Among Adults With Type 2 Diabetes Mellitus Attending Outpatient Clinic Of University Of Nigeria Teaching Hospital Enugu.

ABSTRACT

Chronic diseases such as diabetes mellitus require daily self management and long term

therapies. Regimen adherence poses a unique challenge for patients with chronic illnesses

including diabetics resulting to repeated hospital admissions, amputations and even death.

There is paucity of information on regimen adherence behaviour among diabetic patients

attending diabetic clinic at University of Nigeria Teaching Hospital (UNTH) Enugu. Thus the

study was done to determine the prevalence and associated factors of non adherence among

adults with type 2 diabetes mellitus in UNTH Enugu. A cross sectional study was done and a

researcher- developed- questionnaire was used to collect data from October and December

2010. Majority, 63.5% of the respondents were females while 36.5% were males. Their mean

age was 60.1 years and 88% were married. The prevalence of non adherence to medication

was 24.5%, while 57.5% of the respondents did not have glucometer for self monitoring of

blood glucose. Majority, (86.1%) of those on oral hypoglycaemic agent (OHA) could not

monitor their blood glucose level at least twice weekly, 49.0% of the respondents missed

hospital appointments and most of them, 63.5% were eating irregularly. Age (p 0.006, C I

0.025 – 0.544) and marital status (p 0.025, C I 1.250 – 25.792) were found to be associated

with non adherence to medication. This showed that age and marital status militated against

adherence to medication in the respondents. Cost of transportation (p 0.000, C I 0.069 –

0.472) ,discouraging attitudes of health workers (p 0.003, C I 0.006 – 0.353) and late

commencement of clinics (p 0.006, C I 0.007 – 0.448) were associated with non adherence to

coming for checkups. Based on these findings, it was concluded that there was non adherence

to various aspects of management regimen among the respondents. Recommendations

included that healthcare providers (physicians, nurses, pharmacists ) should screen patients

for non adherence when they report no improvement with their prescribed therapy. Also

communication and patient- provider relationship should be improved and clinic activities

commenced on time.