Mirghani Hyder Osman
Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Saudi Arabia.
Pan Afr Med J. 2019 Sep 16;34:34. doi: 10.11604/pamj.2019.34.34.15161. eCollection 2019.
Adherence to anti-diabetic medication is a known cornerstone in the management of type 2 diabetic patients. We sought to assess the factors associated with adherence to medication s among type 2 diabetic patients being followed up in a Sudanese outpatient clinic.
This cross-sectional study conducted among 102 patients with type 2 diabetes attending an outpatient clinic in Omdurman, Sudan during the period from June to December 2017. Participants were interviewed using a structured questionnaire to collect demographic data, number, and type of medications, polypharmacy, medications side effects, financial problems and education regarding drug used. The study of participants' adherence to anti-diabetic medications was assessed using a validated questionnaire asking the patients about the percent and self-rating of adherence (Excellent, very good, good, fair and poor). The Statistical Package for Social Sciences (SPSS) was used to compare the adherent patients and their counterparts. A P-value < 0.05 was considered significant.
The study results summarized the following: participants (70.6% women), their mean age was (59.62±9.91) years and nearly 60.8% were housewives, their glycated hemoglobin (mean± SD) was about 10.16±3.14, 37.3%, it implies that the patients were non-adherent to medications. In addition, other groups of patients with medication but non-adherence were younger ones (55.94±9.94 vs. 61.81±9.36, P=0.04) and had shown inadequate glycemic control (11.33±3.05vs. 9.47±3.04, P=0.04), however, this group of patients has reported more drug-related side effects (57.8% vs. 28.1%) because they were taking more drugs compared to their counterparts( F=4.115, P=0.047). The present study found no statistically significant differences in the following factors such as sex, occupation, education level, financial problems and insulin use.
In conclusion, the study revealed that adherence to anti-diabetic medications was sub-optimal among Sudanese type 2 diabetic patients and was associated with higher glycated hemoglobin seen among younger age groups. Besides the above, overdosing of medications and their side effects were evident.
坚持服用抗糖尿病药物是2型糖尿病患者管理的一个已知基石。我们试图评估在苏丹一家门诊诊所接受随访的2型糖尿病患者中与药物依从性相关的因素。
这项横断面研究于2017年6月至12月期间在苏丹恩图曼的一家门诊诊所对102例2型糖尿病患者进行。使用结构化问卷对参与者进行访谈，以收集人口统计学数据、药物数量和类型、联合用药、药物副作用、经济问题以及关于所用药物的教育情况。通过一份经过验证的问卷评估参与者对抗糖尿病药物的依从性，该问卷询问患者依从性的百分比和自我评分（优秀、非常好、好、一般和差）。使用社会科学统计软件包（SPSS）对依从性患者及其对应者进行比较。P值<0.05被认为具有统计学意义。
研究结果总结如下：参与者（70.6%为女性），平均年龄为（59.62±9.91）岁，近60.8%为家庭主妇，糖化血红蛋白（平均值±标准差）约为10.16±3.14，37.3%，这意味着患者未坚持服药。此外，其他有药物治疗但不依从的患者群体较年轻（55.94±9.94对61.81±9.36，P = 0.04）且血糖控制不佳（11.33±3.05对9.47±3.04，P = 0.04），然而，这组患者报告的药物相关副作用更多（57.8%对28.1%），因为他们比其对应者服用更多药物（F = 4.115，P = 0.047）。本研究在性别、职业、教育水平、经济问题和胰岛素使用等因素方面未发现统计学上的显著差异。
总之，该研究表明苏丹2型糖尿病患者的抗糖尿病药物依从性欠佳，且与较年轻年龄组中较高的糖化血红蛋白水平相关。除此之外，药物过量及其副作用很明显。
