Effect of Polypharmacy on Medication Adherence in Patients with Type 2 Diabetes mellitus

ABSTRACT Objective: Non-adherence to treatment is an important and often unrecognized risk factor that contributes to reduced control of blood sugar hence this study aims at assessing the level of medication adherence in diabetic patients. It also determines to investigate beliefs about medications held by people with diabetes, and whether these beliefs influence adherence. Methods: This is a cohort study done for six months in which a sample size of 160 members was included. This study was conducted in a tertiary care teaching hospital in south India. The study included participants with at least one cholesterol level measured, one clinic visit in the previous 6 months, prescribed with at least 2 drugs. Out of 160, 125 (78.1%) patients agreed to participate and agreed to be interviewed, 35 (21.8%) refused for adherence assessment and beliefs about medicines interview. The patients were interviewed by using Morisky 8 item medication adherence and beliefs about medicines questionnaire. Results and Discussion: There is no association between the adherence score and the sociodemographic variables like age, gender, level of education, duration of diabetes. Patients with normal weight have high adherence and is statistically significant with a p value of 0.0004. Patients with co morbidities have high morisky medication adherence score when compared to those who don't have co morbidities (p=0.0001). Greater the no. of medicines taken higher the concerns score (p=0.038). Necessity, concerns, and differential necessity-concerns score of adherers and non adherers are not significant. Conclusion: In this sample, patients reported very high medication adherence rates regardless of number of medicines prescribed. Most people with diabetes have positive beliefs about the necessity of their medication. However, levels of concern are also high. Physicians should not feel deterred from prescribing multiple agents in order to achieve adequate control of hyperglycemia, hypertension, and hyperlipidemia