Analysis of treatment satisfaction and adherence among patients with type 2 diabetes

Abstract

Background: Low treatment adherence in patients with type 2 diabetes mellitus (T2DM) hinders the effective use of anti-diabetic agents and the achievement of glycemic control, reducing their quality of life and outcomes. Assessment of treatment adherence can help to identify and manage factors and barriers that affect therapy and treatment satisfaction.Aim: To assess the treatment adherence of patients with T2DM, to identify the main barriers to adherence, and patient satisfaction with the treatment.Materials and methods: FORSIGHT-T2DM was a  Russian multiregional, multicenter observational epidemiological study in 2014 patients with T2DM. The patients were assessed with the FORSIGHT- T2DM Patient Questionnaire, Moriski Medication Adherence Scale (MMAS), and Diabetes Treatment Satisfaction Questionnaire (DTSQ).Results: The mean (± SD) treatment adherence estimated using the MMAS was 5.86±1.39 points. The main barriers to adherence were high treatment costs, medication side effects, forgetfulness when taking drugs, complexity of the therapy or treatment regimen. The average number of daily medications was four. There was also a lack of contact with a doctor, poor awareness of the disease and its complications. Ninety (90) per cent of the respondents trusted the recommendations from their doctors, 7.6% followed the advice of relatives or friends. The patient's choice of medication was influenced by information about its effectiveness, its cost, and reimbursement, ease of administration, and information on the absence of side effects. Seventy eight (78) per cent of the respondents were “completely” or “rather” satisfied with their treatment. About 15% of patients rated the quality of care as unsatisfactory.Conclusion: The results of the study identified an intermediate level of treatment adherence in most patients with T2DM, as well as multiple adherence barriers, including comorbidities and the need for continuous intake of various agents. Most patients showed high treatment satisfaction, which could be due to the high availability of outpatient consultations by an endocrinologist and inpatient treatment, free access to anti-diabetic medications. However, it may also be a  result of biased assessment of problems due to insufficient patient awareness of the therapy goals and a low level of knowledge about their disease. To study the factors affecting the adherence to medical recommendations among patients with T2DM, it is necessary to develop a  specific questionnaire for this patient category, which would allow for an evaluation both drug intake and other aspects of their comprehensive treatment, including the identification and analysis of the main barriers to adherence.