Alqarni Abdullah M, Alrahbeni Tahani, Qarni Ayidh Al, Qarni Hassan M Al
Clinical Pharmacy Department, Bisha Health Affairs, Ministry of Health, Bisha, Saudi Arabia,
Department of Pharmacy and Allied Sciences, Riyadh Elm University, Riyadh, Saudi Arabia,
Patient Prefer Adherence. 2018 Dec 24;13:63-71. doi: 10.2147/PPA.S176355. eCollection 2019.
Patients' non-adherence to diabetes medication is associated with poor glycemic control and suboptimal benefits from their prescribed medication, which can lead to worsening of medical condition, development of comorbidities, reduced quality of life, elevated health care costs, and increased mortality.
This study aimed to assess medication adherence among patients with diabetes and associated factors in Bisha primary health care centers (PHCCs) in Saudi Arabia.
A cross-sectional study was conducted with a sample of 375 type 1 and 2 Saudi diabetic patients attending PHCCs under the Health Affairs of the Bisha governorate. The participants were aged 18 years and above, and had been taking diabetes medications for at least 3 months. Pregnant women, patients with mental illnesses, and those who were not willing to participate were excluded. Adherence to diabetes medications was measured using the four-item Morisky Green Levine Medication Adherence Scale (MGLS). All participants completed a self-report questionnaire including sociodemographic and clinical variables. Univariate and multivariate analyses were carried out using SPSS version 22.
Of all the respondents, 134 (35.7%), 161 (42.9%), and 80 (21.4%), patients had high (MGLS score 0), intermediate (MGLS score 1 or 2), and low adherence (MGLS score ≥3), respectively. Factors associated with the level of adherence in univariate analysis were occupational status (=0.037), current medication (<0.001), glycated hemoglobin (A1c) (<0.001), and number of associated comorbidities (<0.001). In multivariable analyses, A1c <7 (<0.001) and no associated comorbidities (<0.003) variables remained significantly associated with adherence.
The level of adherence to medication in diabetes mellitus patients in the Bisha PHCCs was found to be suboptimal. The findings point toward the need for better management of primary health care providers' approaches to individual patients, by taking into account their medication adherence levels. Better identification of patients' level of adherence remains essential for successful diabetes treatment.
患者不坚持服用糖尿病药物与血糖控制不佳以及所开药物的益处未达最佳水平相关，这可能导致病情恶化、出现合并症、生活质量下降、医疗费用增加以及死亡率上升。
本研究旨在评估沙特阿拉伯比沙初级卫生保健中心（PHCCs）糖尿病患者的药物依从性及相关因素。
进行了一项横断面研究，样本为375名在比沙省卫生事务部下属PHCCs就诊的1型和2型沙特糖尿病患者。参与者年龄在18岁及以上，且服用糖尿病药物至少3个月。排除孕妇、患有精神疾病的患者以及不愿参与的患者。使用四项Morisky Green Levine药物依从性量表（MGLS）测量糖尿病药物的依从性。所有参与者完成一份自我报告问卷，包括社会人口统计学和临床变量。使用SPSS 22版进行单因素和多因素分析。
在所有受访者中，分别有134名（35.7%）、161名（42.9%）和80名（21.4%）患者具有高依从性（MGLS评分为0）、中等依从性（MGLS评分为1或2）和低依从性（MGLS评分≥3）。单因素分析中与依从性水平相关的因素有职业状况（=0.037）、当前用药（<0.001）、糖化血红蛋白（A1c）（<0.001）以及合并症数量（<0.001）。在多因素分析中，A1c<7（<0.001）和无合并症（<0.003）变量仍与依从性显著相关。
发现比沙PHCCs糖尿病患者的药物依从性水平未达最佳。研究结果表明，需要通过考虑患者的药物依从性水平，更好地管理初级卫生保健提供者针对个体患者的治疗方法。更好地识别患者的依从性水平对于糖尿病的成功治疗仍然至关重要。
