Compliance to Anti-Diabetic Drugs: Observations from the Diabetic Clinic of a Medical College in Kolkata, India 661-665
Dr. Shuvankar Mukherjee,
Assistant Professor, Department of Community Medicine,
GEOS Cooperative, Flat No. 201,
H-31, Baishnabghata Patuli Township,
Kolkata â€“ 94, West Bengal, PIN - 700094, India.
Background: The poor glycaemic control among the patients with type 2 diabetes constitutes a major public health problem and a major risk factor for the development of diabetes complications.
Aim of the Study: To study the compliance rate of the patients with type 2 diabetes to the prescribed medications, to find out its correlation with different socio-demographic factors and other patient characteristics and to find out the reasons behind the non-compliance, if any.
Settings and Design: This cross sectional study was conducted on the patients with type 2 diabetes, who Attended the Diabetic Clinic of a Medical College in Kolkata, India.
Methods and Material: The patients of type 2 diabetes who attended the diabetes clinic between April to August 2012 were recruited in the study by systematic random sampling and they were interviewed by using the help of a structured interview schedule. The patients who reported taking less than 80% of their prescribed anti-diabetes medicines in the preceding week and had HbA1C of > 7% were considered to be non-compliant.
Statistical Analysis Used: The data was analyzed by using the SPSS software. The Chi-square test was used to assess the association of the compliance with the different study variables. A binary logistic regression analysis helped in identifying the factors which contributed to the non-compliance.
Results: The compliance rate to the anti-diabetic drugs was found to be 57.7%. A univariate analysis showed that it decreased significantly with increasing age and that it was also significantly lower among males, illiterates, those with a poor per capita monthly income and those who had a longer duration of diabetes. It varied significantly with the type of drugs, being lowest with an oral drug and insulin combination (43.4%). No knowledge on the complications of diabetes was significantly associated with a lower compliance. The binary logistic regression also helped in identifying these as the significant contributory factors. The common reasons behind the non-compliance were forgetfulness (44.7%) and financial constraints (32.7%).
Conclusion: It can be concluded that the compliance to anti-diabetic drugs was quite poor among the participants. Increasing age, the male sex, illiteracy, a low monthly income and a longer duration of diabetes were significantly associated with the non compliance. A more concerning fact was the significant association of the non-compliance with the types of drug regimens and a lack of knowledge on the complications of diabetes, which emphasized the role of a repeated patient education regarding the basic aspects of diabetes.