Iqbal Qaiser, Bashir Sajid, Iqbal Javeid, Iftikhar Shehla, Godman Brian
a Faculty of Pharmacy & Health Sciences , University of Balochistan , Quetta , Pakistan.
b Faculty of Pharmacy , University of Sargodha , Punjab , Pakistan.
Postgrad Med. 2017 Aug;129(6):637-643. doi: 10.1080/00325481.2017.1328251. Epub 2017 May 24.
Type 2 diabetes (T2DM) is a growing burden among all countries including Pakistan, with medication adherence very important to improve care. However, little is known about medication adherence in Pakistan and potential predictors among T2DM patients to provide future guidance. This needs to be addressed. Consequently, the present study sought to assess medication adherence among type 2 diabetic patients in Quetta city, Pakistan.
Questionnaire based, descriptive study among 300 Pakistani patients attending public and private hospitals aged 18 years and above, having a confirmed diagnosis of T2DM, without additional co-morbidities were targeted. Descriptive statistics were used to describe demographic and disease characteristics. The association between socio-demographic data and study variables was compared through the Mann Whitney/Kruskal Wallis test (where applicable). The factors that were significantly associated with medication adherence were further assessed by logistic regression analysis.
55.6% of patients had high adherence although overall patients reported moderate adherence. Age, gender, education, diabetes-related knowledge and treatment satisfaction were significantly associated with medication adherence. Older males with only primary education and with poor diabetes-related knowledge had the lowest adherence.
This study presents a model that is associated with medication adherence among T2DM patients, with disease-related knowledge as a significant predictor of likely adherence. Results of the current study revealed that improved diabetes related knowledge plays a significant role in improving medication adherence. Healthcare practitioners and the system should formalize and acknowledge patient education as a key component to treat patients with T2DM. This should include a greater role for pharmacists and other professionals.
2型糖尿病（T2DM）在包括巴基斯坦在内的所有国家中都是日益加重的负担，药物依从性对于改善治疗非常重要。然而，对于巴基斯坦的药物依从性以及T2DM患者中的潜在预测因素知之甚少，这需要加以解决。因此，本研究旨在评估巴基斯坦奎达市2型糖尿病患者的药物依从性。
以问卷调查为基础，对300名年龄在18岁及以上、确诊为T2DM且无其他合并症的巴基斯坦公立和私立医院患者进行描述性研究。使用描述性统计来描述人口统计学和疾病特征。通过Mann Whitney/Kruskal Wallis检验（适用时）比较社会人口统计学数据与研究变量之间的关联。通过逻辑回归分析进一步评估与药物依从性显著相关的因素。
55.6%的患者具有高依从性，尽管总体患者报告的是中度依从性。年龄、性别、教育程度、糖尿病相关知识和治疗满意度与药物依从性显著相关。仅接受过小学教育、糖尿病相关知识较差的老年男性依从性最低。
本研究提出了一个与T2DM患者药物依从性相关的模型，其中疾病相关知识是可能依从性的重要预测因素。当前研究结果表明，改善糖尿病相关知识在提高药物依从性方面发挥着重要作用。医疗从业者和医疗系统应将患者教育正式化并确认为治疗T2DM患者的关键组成部分。这应包括药剂师和其他专业人员发挥更大作用。
