Medication-taking behaviour in New South Wales patients with type 2 diabetes: an observational study
Teerapon Dhippayom A B and Ines Krass B CA Pharmaceutical Care Research Unit, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, 65000, Thailand.
B Faculty of Pharmacy, The University of Sydney, Science Road, NSW 2006, Australia.
C Corresponding author. Email: ines.krass@sydney.edu.au
Australian Journal of Primary Health 21(4) 429-437 https://doi.org/10.1071/PY14062
Submitted: 4 April 2014 Accepted: 3 August 2014 Published: 3 September 2014
Abstract
This study aimed to (1) determine adherence to diabetes medication in type 2 diabetes (T2D) patients; (2) describe respondents’ attitudes and beliefs about medications, and barriers to adherence; and (3) to model predictors of non-adherence. Data were collected using online and postal surveys. Diabetes patients aged ≥18 years who were members of the Australian Diabetes Council were invited to participate. Main outcome measures were adherence to diabetes medication using 8-item Morisky Medication Adherence Score (MMAS-8) and beliefs about medication using the Beliefs about Medicines Questionnaire. A total of 543 T2D patients responded to the survey. The median (interquartile range) MMAS-8 score was 6.8 (5.0–7.0). The prevalence of adherence (MMAS-8 score ≥6) was 64.6%. The proportion of respondents who expressed concern about taking medications was 53.6%. Potential predictors of adherence included age (OR, 1.83; 95% CI, 1.19–2.82), concern about medication (OR, 0.91; 95% CI, 0.87–0.96), knowledge of diabetes (OR, 0.85, 95% CI, 0.73–0.99), having difficulty in paying for medication (OR, 0.51; 95% CI ,0.33–0.79), having more than one regular pharmacy (OR, 0.59; 95% CI, 0.36–0.95), and using insulin (OR, 0.49; 95% CI, 0.30–0.81). Adherence to taking diabetes medication in a sample of the Australian T2D patient population was suboptimal. An understanding of medication-taking behaviour will assist health-care professionals to deliver appropriate and effective interventions to enhance adherence and optimise diabetes control in T2D patients.
Additional keywords: adherence, attitudes, factors, medication adherence.
References
Adeyemi AO, Rascati KL, Lawson KA, Strassels SA (2012) Adherence to oral antidiabetic medications in the pediatric population with type 2 diabetes: a retrospective database analysis. Clinical Therapeutics 34, 712–719.| Adherence to oral antidiabetic medications in the pediatric population with type 2 diabetes: a retrospective database analysis.Crossref | GoogleScholarGoogle Scholar | 22381712PubMed |
Aflakseir A (2012) Role of illness and medication perceptions on adherence to medication in a group of Iranian patients with type 2 diabetes. Journal of Diabetes 4, 243–247.
| Role of illness and medication perceptions on adherence to medication in a group of Iranian patients with type 2 diabetes.Crossref | GoogleScholarGoogle Scholar | 22221835PubMed |
Bailey GR, Barner JC, Weems JK, Leckbee G, Solis R, Montemayor D, Pope ND (2012) Assessing barriers to medication adherence in underserved patients with diabetes in Texas. The Diabetes Educator 38, 271–279.
| Assessing barriers to medication adherence in underserved patients with diabetes in Texas.Crossref | GoogleScholarGoogle Scholar | 22316643PubMed |
Barnes L, Moss-Morris R, Kaufusi M (2004) Illness beliefs and adherence in diabetes mellitus: a comparison between Tongan and European patients. The New Zealand Medical Journal 117, U743
Blackburn DF, Swidrovich J, Lemstra M (2013) Non-adherence in type 2 diabetes: practical considerations for interpreting the literature. Patient Prefer Adherence 7, 183–189.
| Non-adherence in type 2 diabetes: practical considerations for interpreting the literature.Crossref | GoogleScholarGoogle Scholar | 23487395PubMed |
Briesacher BA, Andrade SE, Fouayzi H, Chan KA (2008) Comparison of drug adherence rates among patients with seven different medical conditions. Pharmacotherapy 28, 437–443.
| Comparison of drug adherence rates among patients with seven different medical conditions.Crossref | GoogleScholarGoogle Scholar | 18363527PubMed |
Cramer JA (2004) A systematic review of adherence with medications for diabetes. Diabetes Care 27, 1218–1224.
| A systematic review of adherence with medications for diabetes.Crossref | GoogleScholarGoogle Scholar | 15111553PubMed |
Cramer JA, Benedict A, Muszbek N, Keskinaslan A, Khan ZM (2008) The significance of compliance and persistence in the treatment of diabetes, hypertension and dyslipidaemia: a review. International Journal of Clinical Practice 62, 76–87.
| The significance of compliance and persistence in the treatment of diabetes, hypertension and dyslipidaemia: a review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c%2FgslSlsg%3D%3D&md5=895e3308cf60e398c01c6980249c3953CAS | 17983433PubMed |
del Rey-Moya LM, Castilla-Alvarez C, Pichiule-Castaneda M, Rico-Blazquez M, Escortell-Mayor E, Gomez-Quevedo R (2013) Effect of a group intervention in the primary healthcare setting on continuing adherence to physical exercise routines in obese women. Journal of Clinical Nursing 22, 2114–2121.
| Effect of a group intervention in the primary healthcare setting on continuing adherence to physical exercise routines in obese women.Crossref | GoogleScholarGoogle Scholar | 23829402PubMed |
Farmer A, Kinmonth AL, Sutton S (2006) Measuring beliefs about taking hypoglycaemic medication among people with type 2 diabetes. Diabetic Medicine 23, 265–270.
| Measuring beliefs about taking hypoglycaemic medication among people with type 2 diabetes.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD287gsFyrsw%3D%3D&md5=08c6fe6bfc9724922cd1b28ba36ba758CAS | 16492209PubMed |
Gonzalez JS, Schneider HE (2011) Methodological issues in the assessment of diabetes treatment adherence. Current Diabetes Reports 11, 472–479.
| Methodological issues in the assessment of diabetes treatment adherence.Crossref | GoogleScholarGoogle Scholar | 21956675PubMed |
Haywood A, Llewelyn V, Robertson S, Mylrea M, Glass B (2011) Dose administration aids: pharmacists’ role in improving patient care. Australasian Medical Journal 4, 183–189.
| Dose administration aids: pharmacists’ role in improving patient care.Crossref | GoogleScholarGoogle Scholar |
Haltiwanger EP (2012) Effect of a group adherence intervention for Mexican-American older adults with type 2 diabetes. The American Journal of Occupational Therapy 66, 447–454.
| Effect of a group adherence intervention for Mexican-American older adults with type 2 diabetes.Crossref | GoogleScholarGoogle Scholar | 22742693PubMed |
Horne R, Weinman J, Hankins M (1999) The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychology & Health 14, 1–24.
| The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication.Crossref | GoogleScholarGoogle Scholar |
Horne R, Chapman SC, Parham R, Freemantle N, Forbes A, Cooper V (2013) Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. PLoS ONE 8, e80633
| Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework.Crossref | GoogleScholarGoogle Scholar | 24312488PubMed |
Hunt J, Rozenfeld Y, Shenolikar R (2009) Effect of patient medication cost share on adherence and glycemic control. Managed Care (Langhorne, Pa.) 18, 47–53.
Jamous RM, Sweileh WM, Abu-Taha AS, Sawalha AF, Zyoud SH, Morisky DE (2011) Adherence and satisfaction with oral hypoglycemic medications: a pilot study in Palestine. International Journal of Clinical Pharmacology, Therapy and Toxicology 33, 942–948.
| Adherence and satisfaction with oral hypoglycemic medications: a pilot study in Palestine.Crossref | GoogleScholarGoogle Scholar |
Kemp A, Roughead E, Preen D, Glover J, Semmens J (2010) Determinants of self-reported medicine underuse due to cost: a comparison of seven countries. Journal of Health Services Research & Policy 15, 106–114.
| Determinants of self-reported medicine underuse due to cost: a comparison of seven countries.Crossref | GoogleScholarGoogle Scholar |
Khan AR, Al-Abdul Lateef ZN, Al Aithan MA, Bu-Khamseen MA, Al Ibrahim I, Khan SA (2012) Factors contributing to non-compliance among diabetics attending primary health centers in the Al Hasa district of Saudi Arabia. Journal of Family & Community Medicine 19, 26–32.
| Factors contributing to non-compliance among diabetics attending primary health centers in the Al Hasa district of Saudi Arabia.Crossref | GoogleScholarGoogle Scholar |
Krass I, Taylor SJ, Smith C, Armour CL (2005) Impact on medication use and adherence of Australian pharmacists’ diabetes care services. Journal of the American Pharmacists Association (2003) 45, 33–40.
| Impact on medication use and adherence of Australian pharmacists’ diabetes care services.Crossref | GoogleScholarGoogle Scholar |
Kripalani S, Yao X, Haynes RB (2007) Interventions to enhance medication adherence in chronic medical conditions: a systematic review. Archives of Internal Medicine 167, 540–550.
| Interventions to enhance medication adherence in chronic medical conditions: a systematic review.Crossref | GoogleScholarGoogle Scholar | 17389285PubMed |
Larkin ME, Capasso VA, Chen CL, Mahoney EK, Hazard B, Cagliero E, Nathan DM (2008) Measuring psychological insulin resistance: barriers to insulin use. The Diabetes Educator 34, 511–517.
| Measuring psychological insulin resistance: barriers to insulin use.Crossref | GoogleScholarGoogle Scholar | 18535324PubMed |
Lau CY, Qureshi AK, Scott SG (2004) Association between glycaemic control and quality of life in diabetes mellitus. Journal of Postgraduate Medicine 50, 189–193, discussion 194.
Lee DY-L (2008) The development and evaluation of written medicines information (WMI) for patients with type 2 diabetes. PhD thesis. The University of Sydney, Sydney.
Lee CM, Colagiuri R, Magliano DJ, Cameron AJ, Shaw J, Zimmet P, Colagiuri S (2013a) The cost of diabetes in adults in Australia. Diabetes Research and Clinical Practice 99, 385–390.
| The cost of diabetes in adults in Australia.Crossref | GoogleScholarGoogle Scholar | 23298663PubMed |
Lee S, Khan OF, Seo JH, Kim DY, Park KH, Jung SI, Chung EK, Jang HC (2013b) Impact of physician’s education on adherence to tuberculosis treatment for patients of low socioeconomic status in Bangladesh. Chonnam Medical Journal 49, 27–30.
| Impact of physician’s education on adherence to tuberculosis treatment for patients of low socioeconomic status in Bangladesh.Crossref | GoogleScholarGoogle Scholar | 23678474PubMed |
Marcum ZA, Zheng Y, Perera S, Strotmeyer E, Newman AB, Simonsick EM, Shorr RI, Bauer DC, Donohue JM, Hanlon JT (2013) Prevalence and correlates of self-reported medication non-adherence among older adults with coronary heart disease, diabetes mellitus, and/or hypertension. Research in Social & Administrative Pharmacy 9, 817–827.
| Prevalence and correlates of self-reported medication non-adherence among older adults with coronary heart disease, diabetes mellitus, and/or hypertension.Crossref | GoogleScholarGoogle Scholar |
Meece J (2014) Improving medication adherence among patients with type 2 diabetes. Journal of Pharmacy Practice 27, 187–194.
| Improving medication adherence among patients with type 2 diabetes.Crossref | GoogleScholarGoogle Scholar | 24375997PubMed |
Morisky DE, Ang A, Krousel-Wood M, Ward HJ (2008) Predictive validity of a medication adherence measure in an outpatient setting. Journal of Clinical Hypertension 10, 348–354.
| Predictive validity of a medication adherence measure in an outpatient setting.Crossref | GoogleScholarGoogle Scholar | 18453793PubMed |
Nguyen TM, Caze AL, Cottrell N (2013) What are validated self-report adherence scales really measuring?: a systematic review. British Journal of Clinical Pharmacology 77, 427–445.
| What are validated self-report adherence scales really measuring?: a systematic review.Crossref | GoogleScholarGoogle Scholar |
Obreli-Neto PR, Guidoni CM, de Oliveira Baldoni A, Pilger D, Cruciol-Souza JM, Gaeti-Franco WP, Cuman RK (2011) Effect of a 36-month pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients. International Journal of Clinical Pharmacology, Therapy and Toxicology 33, 642–649.
| Effect of a 36-month pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients.Crossref | GoogleScholarGoogle Scholar |
Piette JD, Heisler M, Harand A, Juip M (2010) Beliefs about prescription medications among patients with diabetes: variation across racial groups and influences on cost-related medication underuse. Journal of Health Care for the Poor and Underserved 21, 349–361.
| Beliefs about prescription medications among patients with diabetes: variation across racial groups and influences on cost-related medication underuse.Crossref | GoogleScholarGoogle Scholar | 20173274PubMed |
Sakthong P, Chabunthom R, Charoenvisuthiwongs R (2009) Psychometric properties of the Thai version of the 8-item Morisky Medication Adherence Scale in patients with type 2 diabetes. The Annals of Pharmacotherapy 43, 950–957.
| Psychometric properties of the Thai version of the 8-item Morisky Medication Adherence Scale in patients with type 2 diabetes.Crossref | GoogleScholarGoogle Scholar | 19366872PubMed |
Schoenthaler AM, Schwartz BS, Wood C, Stewart WF (2012) Patient and physician factors associated with adherence to diabetes medications. The Diabetes Educator 38, 397–408.
| Patient and physician factors associated with adherence to diabetes medications.Crossref | GoogleScholarGoogle Scholar | 22446035PubMed |
Segador J, Gil-Guillen VF, Orozco D, Quirce F, Carratala MC, Fernandez-Parker A, Merino J (2005) The effect of written information on adherence to antibiotic treatment in acute sore throat. International Journal of Antimicrobial Agents 26, 56–61.
| The effect of written information on adherence to antibiotic treatment in acute sore throat.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2MXlvVWlurY%3D&md5=d19326ea50bb9513dd5b5a586edb30e2CAS | 15961289PubMed |
Sevick MA, Korytkowski M, Stone RA, Piraino B, Ren D, Sereika S, Wang Y, Steenkiste A, Burke LE (2012) Biophysiologic outcomes of the Enhancing Adherence in Type 2 Diabetes (ENHANCE) trial. Journal of the Academy of Nutrition and Dietetics 112, 1147–1157.
| Biophysiologic outcomes of the Enhancing Adherence in Type 2 Diabetes (ENHANCE) trial.Crossref | GoogleScholarGoogle Scholar | 22818724PubMed |
Shams MEE, Barakat EAME (2010) Measuring the rate of therapeutic adherence among outpatients with T2DM in Egypt. Saudi Pharmaceutical Journal 18, 225–232.
| Measuring the rate of therapeutic adherence among outpatients with T2DM in Egypt.Crossref | GoogleScholarGoogle Scholar |
Shi L, Liu J, Fonseca V, Walker P, Kalsekar A, Pawaskar M (2010) Correlation between adherence rates measured by MEMS and self-reported questionnaires: a meta-analysis. Health and Quality of Life Outcomes 8, 99
| Correlation between adherence rates measured by MEMS and self-reported questionnaires: a meta-analysis.Crossref | GoogleScholarGoogle Scholar | 20836888PubMed |
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR (2000) Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321, 405–412.
| Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvisFWnsg%3D%3D&md5=0c2416a839dec1345e72eb6c44eda99fCAS | 10938048PubMed |
Svarstad BL, Chewning BA, Sleath BL, Claesson C (1999) The Brief Medication Questionnaire: a tool for screening patient adherence and barriers to adherence. Patient Education and Counseling 37, 113–124.
| The Brief Medication Questionnaire: a tool for screening patient adherence and barriers to adherence.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3svmslWgtw%3D%3D&md5=d079bdf313a9616ffaeb9dffaf470ef1CAS | 14528539PubMed |
Trief PM, Izquierdo R, Eimicke JP, Teresi JA, Goland R, Palmas W, Shea S, Weinstock RS (2013) Adherence to diabetes self care for white, African-American and Hispanic American telemedicine participants: 5 year results from the IDEATel project. Ethnicity & Health 18, 83–96.
| Adherence to diabetes self care for white, African-American and Hispanic American telemedicine participants: 5 year results from the IDEATel project.Crossref | GoogleScholarGoogle Scholar |
Vervloet M, van Dijk L, Santen-Reestman J, van Vlijmen B, van Wingerden P, Bouvy ML, de Bakker DH (2012) SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored. International Journal of Medical Informatics 81, 594–604.
| SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38nnvVSksw%3D%3D&md5=cee0d49df540c542dc8bbc2cbd761e07CAS | 22652012PubMed |
Whiting DR, Guariguata L, Weil C, Shaw J (2011) IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Research and Clinical Practice 94, 311–321.
| IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030.Crossref | GoogleScholarGoogle Scholar | 22079683PubMed |
Wong MC, Kong AP, So WY, Jiang JY, Chan JC, Griffiths SM (2011) Adherence to oral hypoglycemic agents in 26,782 Chinese patients: a cohort study. Journal of Clinical Pharmacology 51, 1474–1482.
| Adherence to oral hypoglycemic agents in 26,782 Chinese patients: a cohort study.Crossref | GoogleScholarGoogle Scholar | 21098691PubMed |
Yusuf F, Leeder SR (2013) Can’t escape it: the out-of-pocket cost of health care in Australia. The Medical Journal of Australia 199, 475–478.
| Can’t escape it: the out-of-pocket cost of health care in Australia.Crossref | GoogleScholarGoogle Scholar | 24099208PubMed |
Zhang P, Zhang X, Brown J, Vistisen D, Sicree R, Shaw J, Nichols G (2010) Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes Research and Clinical Practice 87, 293–301.
| Global healthcare expenditure on diabetes for 2010 and 2030.Crossref | GoogleScholarGoogle Scholar | 20171754PubMed |