Improving adherence to medication in adults with diabetes in the United Arab Emirates.

BACKGROUND: Diabetes is a chronic medical condition and adherence to medication in diabetes is important. Improving medication adherence in adults with diabetes would help prevent the chronic complications associated with diabetes. A case control trial was used to study the effects of an educational session on medication adherence among adults with diabetes as measured by the Morisky Medication adherence scale (MMAS-8©). METHODS: The study took place at the Dubai Police Health Centre between February 2015 and November 2015. Questionnaires were used to collect socio-demographic, clinical and disease related variables and the primary measure of outcome was adherence levels as measured by the Morisky Medication Adherence Scale (MMAS-8©). The intervention group involved a standardized thirty minute educational session focusing on the importance of adherence to medication. The change in MMAS-8© was measured at 6 months. RESULTS: Four hundred and forty six patients were enrolled. Mean age 61 year +/- 11. 48.4 % were male. The mean time since diagnosis of diabetes was 3.2 years (Range 1-15 years). At baseline two hundred and eighty eight (64.6 %) patients were considered non-adherent (MMAS-8© adherence score < 6) while 118 (26.5 %) and 40 (9.0 %) had low adherence (MMAS-8© adherence score < 6) and medium adherence (MMAS-8© adherence scores of 6 to 7) to their medication respectively. The percentage of patients scoring low adherence MMAS-8 scores in the interventional group dropped from 64.60 % at baseline to 44.80 % at 6-months (p = 0.01). There was no obvious change in the adherence scores at baseline and at 6-months in the control group. Based on the study data, the Wilcoxon signed-rank test showed that at 6 months, the educational 30-min session on diabetes and adherence to medication did elicit a statistically significant change in adherence levels in adults with diabetes enrolled in the intervention arm (Z = -6.187, p <0.001). CONCLUSION: Adults with diabetes would benefit from educational sessions focusing on the importance of adherence to medication. Public health strategies should focus on wider educational strategies targeting medication adherence in diabetic patients in the UAE.

The predictors to medication adherence among adults with diabetes in the United Arab Emirates.

BACKGROUND: Diabetes is a chronic medical condition and adherence to medication in adults with diabetes is important. Identifying predictors to medication adherence in adults with diabetes would help identify vulnerable patients who are likely to benefit by improving their adherence levels. METHODS: We conducted a cross-sectional study at the Dubai Police Health Centre between February 2015 and November 2015. Questionnaires were used to collect socio-demographic, clinical and disease related variables and the primary measure of outcome was adherence levels as measured by the Morisky Medication Adherence Scale (MMAS-8©). Multivariate logistic regression was carried out to identify predictors to adherence. RESULTS: Four hundred and forty six patients were interviewed. Mean age 61 year +/- 11. 48.4 % were male. The mean time since diagnosis of diabetes was 3.2 years (Range 1-15 years). Two hundred and eighty eight (64.6 %) patients were considered non-adherent (MMAS-8© adherence score < 6) while 118 (26.5 %) had moderate adherence (MMAS-8© adherence score 6 = <8) and 40 (9.0 %) high adherence (MMAS-8© adherence scores <8) to their medication respectively. The strongest predictor for adherence as predicted by the multi-logistic regression model was the patient's level of education. A technical diploma certificate as compared to a primary school level of education was the strongest predictor of adherence (OR = 66.1 CI: 6.93 to 630.43); p < 0.001). The patient's age was also a predictor of adherence with older patients reporting higher levels of adherence (OR = 1.113 (CI: 1.045 to 1.185; p = 0.001 for every year increase in age). The duration of diabetes was also a predictor of adherence (OR = 1.830 (CI: 1.270 to 2.636; p = 0.001 for every year increase in the duration of diabetes). Other predictors to medication adherence include Insulin use, ethnicity and certain cultural behaviours. CONCLUSION: A number of important predictors to medication adherence in diabetics were identified in this study. Such predictors could help develop policies for improving adherence in diabetics.