Health-related quality of life and associated factors among patients with diabetes mellitus in Botswana

Background: Health-related quality of life (HRQOL) is an important aspect of diabetes mellitus care. The objective of the study was to determine the HRQOL of diabetes mellitus (DM) patients in Botswana as little known in Africa. Materials and methods: A cross-sectional study of 380 randomly selected DM patients in a tertiary clinic in Gaborone, Botswana was conducted to obtain Data on HRQOL and structured questionnaire was used to collect information on sociodemographic and clinical characteristics. Multivariate logistic regression to determine sociodemographic and clinical characteristics associated. Results: Majority of patients were female with no formal education or primary level of education. Mean HbA1c was 7.97% (SD: 2.02) and most patients had poor glycemic control. The majority had both worse physical composite score (PCS-12) and mental composite score (MCS-12), with worse proportions of the two. Female gender, older age ≥ 65 years, and the presence of three or more documented diabetic complications were associated with significant worse PCS-12. Presence of two diabetic complications, three or more diabetic complications, and musculoskeletal disease were associated with significant MCS-12. Conclusions: Diabetic patients in Botswana have relatively poor HRQOL. The fact that most patients present late with complications calls for policy attention to diagnose diabetes mellitus early and prevent associated complications, ultimately improving health-related quality of life among diabetes mellitus patients

Antidiabetic medication adherence and associated factors among patients in Botswana; implications for the future

Background: Diabetes mellitus (DM) is a major global public health problem. Lack of adherence to medication causes suboptimal glycemic control increasing complication rates, costs and mortality. The objective of the study was to determine current antidiabetic medication adherence in Botswana and assess associated factors so as to direct potential future interventions. Materials and methods: A cross-sectional study among 376 randomly selected diabetic patients attending a leading clinic in Gaborone, Botswana. Eight item Morisky Medication adherence questionnaire was used to assess antidiabetic medication adherence. A structured questionnaire was also used to collect information on factors influencing adherence including age, gender, education, type and duration of diabetes, treatment, complications and HIV status. Data were entered and analyzed using STATA Version 14, and logistic regression performed. Results: Over forty percent (41.8%) of patients were non-adherent to antidiabetic medications. Studied sociodemographic characteristics and clinical variables did not affect adherence. HIV positive status was associated with a statistically significant better adherence at multivariate analysis. Conclusion: Adherence to antidiabetic medication was found to be suboptimal in a setting where medicines are provided free of charge. Only HIV positivity was found to be significantly associated with better adherence, probably due to effect of greater psychosocial support and counselling as part of HIV treatment. There is a need to carry out studies to further improve understanding of factors associated with medication adherence that are pertinent to Botswana and similar settings given the growing prevalence of diabetes