Fedrick Francis, Justin-Temu M
School of Pharmacy, Muhimbili University of Health and Allied Sciences.
East Afr J Public Health. 2012 Sep;9(3):90-5.
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.
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.
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. Alcohol use, medication side effects and distance travelled to reach the clinic were the significant contributors to non-adherence (p = 0.001).
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. 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.
不遵守糖尿病治疗方案可能是糖尿病患者健康状况不佳的最常见原因。不遵守糖尿病治疗方案任务的发生率差异很大，但对糖尿病治疗效果和治疗有效性有重大影响。
本研究的目的是确定姆万扎市诊所就诊的糖尿病患者中不遵守治疗方案的比例（程度）及其影响因素。具体而言，该研究确定了不遵守治疗方案与各种变量之间的关系，这些变量包括：饮酒、糖尿病知识、其治疗和并发症、患者到诊所的行程距离以及药物副作用。
对姆万扎市两家糖尿病诊所的272名糖尿病患者进行了访谈。在受访者中，118名（43.4%）为男性。他们的平均年龄为51.22岁（标准差为14.97）。在所有受访者中，255名（93.8%）在糖尿病及其治疗方面知识水平较高，与知识水平较低的受访者相比，这表明知识水平不是导致不遵守治疗方案的重要因素。在272名患者中，77名（28.3%）报告存在不遵守治疗方案的情况。饮酒、药物副作用和到诊所的行程距离是导致不遵守治疗方案的重要因素（p = 0.001）。
发现导致不遵守糖尿病治疗方案的因素包括：饮酒、药物副作用以及大多数患者居住地离诊所较远。为了提高治疗依从性，应持续提供从患者角度出发的信息，内容涉及患者对服药的期望、需求和体验，以及可能有助于他们坚持治疗的因素。
