The Main Factors Influencing Adherence to drug Therapy in Patients with Diabetes Mellitus

Abstract

Introduction: Diabetes mellitus is a disease that requires the patient to strictly adhere to the prescribed treatment throughout his life to prevent the development of various complications of diabetes. The need for repeated daily medication intake, learning knowledge about diabetes, gaining skills of self-monitoring of health indicators (glucose, blood pressure, level of physical activity), visits to healthcare facilities for preventive examinations and treatment is a heavy burden on the patient, reducing the quality of life and motivation to comply with the prescriptions of the attending physician. Objectives: To analyze the level of adherence to drug therapy and its factors in patients with diabetes mellitus. Methods: The survey was carried out over the Internet from November 2020 to February 2021. 434 respondents with diabetes mellitus, aged from 18 to 80, were included into study. Among them there were 221 women (50,92%) and 213 men (49,08%). The proportion of respondents with type 1 diabetes mellitus (T1DM) was 23,96% (n = 104, 95% CI 20,17%–28,22%), with type 2 diabetes mellitus (T2DM) – 76,04% (n = 330, 95% CI 71,78%–79,83%). The survey questionnaire consisted of 2 parts. The first part contained 54 questions related to demographic, socioeconomic, and health status of participants’ along with questions designed to identify respondents’ risk factors, diabetes course and complications, information technology usage in treatment and health management process. The second part of the survey contained 25 questions based on the “Russian universal questionnaire for quantifying adherence to treatment” (KOP-25). The Pearson chi-square test and Cramér's V test of the effect size were used to assess the collected nominal data. Results: A low level of adherence to drug therapy prevailed among all respondents, 38,48% (n = 167). Statistically significant differences in the level of adherence to drug therapy were found among respondents with type 1 diabetes mellitus (p < 0,0001), ones visited the schools of diabetes (p <0,001), respondents with a high level of knowledge about diabetes (p <0,001), respondents who adhered to the prescribed medical regimen (p = 0,001), respondents who visit a doctor at least 1 time per year (p = 0,001), ones who used remote forms of interaction with the attending physician (p <0,001), respondents in younger age groups (p <0,001), respondents with a shorter duration of diabetes mellitus (p = 0,005). Conclusion: The main direction for the quality of life improvement for patients with diabetes mellitus is to increase patients' awareness of possible ways to change their lifestyle while maintaining a high level of adherence to drug therapy using information and communication technologies and telemedicine.