Predictors of poor adherence to antidiabetic therapy in patients with type 2 diabetes: a cross-sectional study insight from Ethiopia.

BACKGROUND: Poor adherence to the medical regimen is a major clinical problem in the management of patients with diabetes. This study sought to investigate the level of medication adherence to antidiabetic therapy and to identify possible predictors of poor adherence. METHODS: A hospital based cross-sectional study was conducted from July 2018 to June 2019 among randomly selected follow-up T2D patients at a hospital diabetes clinic. Data were collected through patient interviews, followed by medical chart review. Adherence to antidiabetic therapy that we assessed patients' responses using validated Brief Medication Questionnaire (BMQ). To identify predictors of poor medication adherence, binary logistic regression analyses were performed using SPSS version 25. Statistical significance was set at p value ≤ 0.05. RESULTS: Of the total 357 study participants, 25% were non-adherent to their antidiabetic therapy. Predictors statistically associated with poor adherence were; being female gender (AOR = 1.71, 95% CI 1.01-2.76), and presence of at least one diabetic complication (AOR = 2.02, 95% CI 1.02-3.22). Participants with having at least primary level of education were more likely to adhere to anti-diabetes medication (AOR = 0.42, 95% CI 0.18-0.96). The most common self-reported reasons for non-adherence were forgetfulness, unavailability of medication plus the unaffordability of anti-diabetes medications. CONCLUSIONS: The proportion of participants' adherent to anti-diabetes therapies was suboptimal. Being female, the presence of chronic diabetic complications and having no formal education were the main predictors of poor adherence. Strategies that aimed at improving adherence to antidiabetic medications deemed to be compulsory.

Assessment of Knowledge, Attitude, and Disposal Practice of Unused and Expired Pharmaceuticals in Community of Adigrat City, Northern Ethiopia.

Background: Medicines have become part of our day-to-day life. Due to different reasons, patients may not use all the medications dispensed to them. The storage of drugs at home promotes self-medication, which results in variety of adverse consequences. Global growth in health-seeking awareness and behavior among people has resulted in increment of medicine consumption over years. However, Ethiopians have little awareness about proper disposal of unused and expired pharmaceuticals. Besides, large quantities remain unused or expired since not all medications given to the consumers are consumed. Hence, this study could serve as an indicator for the country policy makers concerning pharmaceutical waste management. Objective: To assess knowledge, attitude, and disposal practice of unused and expired pharmaceuticals in the community of Adigrat city, Tigray, Ethiopia, 2019. Methodology. A cross-sectional study was conducted among 359 respondents from the residents of Adigrat city. Semistructured questionnaires, which focused on knowledge, attitudes, and disposal practices for unused and expired medications, were used to collect data from respondents. Epi-data 3.0 suite and the statistical package for social sciences (SPSS) version 20 were used in data entry and analysis. Results: All of the 359 returned questionnaires were valid for data entry and analysis. Of the 359 respondents, 57.7% were men and the majority (93%) were Orthodox Christians. Almost half of the respondents (50.14%) have good knowledge concerning the disposal of unused and expired pharmaceuticals. Most (82.2%) of the respondents have a positive attitude towards the disposal of unused and expired pharmaceuticals. Around fifty-two (52.4) of the respondents had unused medicines stored at home, with analgesics being the most common (41.5%). Around three-quarters (75.2%) and 63% of the respondents discarded unused and expired medicines in the garbage bins, respectively. Conclusion: Although the majority of the respondents had a positive attitude towards the disposal of unused and expired medications, almost half of the sample population were unaware of proper disposal practices. Furthermore, less were inclined to practice proper disposal of unused and expired medications in the city. Therefore, we recommend further studies that focus on how the disposal attitude of the population can influence their knowledge and practice of the disposal of unused and expired medications.

Evaluation of Hypoglycemia and Associated Factors among Patients with Type 1 Diabetes on Follow-Up Care at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

BACKGROUND: Hypoglycemia is one of the most common acute complications of type 1 diabetes mellitus (T1DM). The knowledge of the factors associated with hypoglycemia will help in the prevention and management of the problem. Therefore, this study was conducted to assess hypoglycemia and its associated factors among T1DM patients who attended the diabetes outpatient clinic of St. Paul's Hospital Millennium Medical College (SPHMMC). METHODS: A cross-sectional study was conducted at the diabetes clinic of SPHMMC. Data on sociodemographic and clinical characteristics including duration of diabetes, type of insulin they have been taking, the factors associated with hypoglycemia, and the severity stage of hypoglycemia was obtained. Data was collected using a structured questionnaire and chart review. Multivariate logistic regression model was used to identify factors associated with hypoglycemia. RESULT: Out of the 247 participants who were recruited into the study, 233 (94.3%) of them experienced hypoglycemia. A total of 6.9 events of hypoglycemia per patient per year happened. Particularly, the events were categorized as 3.1 mild events, 2.3 moderate events, and 0.93 severe events of hypoglycemia. Shorter duration of diabetes history (<1 year) was significantly associated with less experience of hypoglycemia (AOR = 0.09, 95% CI: 0.01-0.90). However, blood glucose monitoring at home was found to be significantly associated with more report of hypoglycemia (AOR = 5.77, 95% CI: 1.16-28.66). CONCLUSION: The prevalence of hypoglycemia among T1DM patients was found as substantially high. Self/family blood glucose monitoring at home could not guarantee to minimize the occurrence of hypoglycemia events. Finger stick home blood glucose monitoring should be given a special attention. Therefore, the involvement of health care providers in diabetes care should be encouraged to address the occurrence of hypoglycemia in T1DM patients.