Medication Non-Adherence and Associated Factors Among Diabetic Patients Visiting General Hospitals in the Eastern Zone of Tigrai, Northern Ethiopia

Figures & data

Table 1 Socio-Demographic Characteristics of Study Participants at the General Hospital of Eastern Zone of Tigrai, Ethiopia, from the 15th of March to the 15th of July 2019 (n=321)

Socio-Demographic Characteristics	Adherent	Non-Adherent	Total [Frequency (Percent (%)]
Sex of respondents
Male	65	102	167 (52%)
Female	51	103	154 (48%)
Age of respondents
18–30	19	37	56 (17.4%)
31–40	29	43	72 (22.4%)
41–50	23	32	55 (17.1%)
51–60	17	44	61 (19.0%)
>60	28	49	77 (24.0%)
Marital status
Unmarried	18	39	57 (17.8%)
Married	64	106	170 (53%)
Divorced	16	28	44 (13.7%)
Widowed	18	32	50 (15.6%)
Religion
Orthodox	84	172	265 (79.8%)
Catholic	11	10	21 (6.5%)
Protestant	11	6	17 (5.3%)
Muslim	10	17	27 (8.4%)
Educational level
Unable read and write	46	86	132 (41.1%)
Primary (1–8)	26	42	68 (21.2%)
Secondary (9–12)	21	38	59 (18.4%)
Diploma and above	23	39	62 (19.3%)
Occupation
Governmental employed	24	25	49 (15.3%)
Private employed	5	24	29 (9.0%)
Unemployed	18	34	52 (16.2%)
Student	11	25	36 (11.2%)
Farmer	27	48	75 (23.4%)
Merchants	19	25	44 (13.7%)
Daily labor	5	8	13 (4.0%)
Housewife	7	13	20 (6.2%)
If other specify	0	3	3 (0.9%)
Monthly income in Ethiopian Birr (ETB)
=<500	42	116	158 (49.2%)
500–2000	35	66	101 (31.5%)
> 2000	39	23	62 (19.3%)
Ethnicity
Tigrian	97	188	285 (88.8%)
Kunama	1	5	6 (1.9%)
Erob	7	4	11 (3.4%)
Amara	2	4	6 (1.9%)
Oromo	2	3	5 (1.6%)
Other	7	1	8 (2.5%)
Residence
Urban	80	98	178 (55.5%)
Rural	36	107	143 (44.5%)
Chewing of chat
Yes	8	16	24 (7.5%)
No	108	189	297 (92.5%)
Smoking of cigarette
Yes	6	12	18 (5.6%)
No	110	193	303 (94.4%)
Drinking of alcohol
Yes	28	61	89 (27.7%)
No	88	144	232 (72.3%)
Distance from clinic in kilometers
Less than or equal to 4	42	57	99 (30.8%)
Greater than 4	71	148	219 (69.2%)

Table 2 Clinical, Medication-Related Characteristics and Adherence Level of the Study Participants at General Hospital of Eastern Zone of Tigrai, Ethiopia, from the 15th of March to the 15th of July 2019 (n=321)

Characteristics	Adherent	Non-Adherent	Total [Frequency (Percent (%)]
Duration on DM
> 6 month	24	45	69 (21.5%)
1–5 year	51	80	131 (40.8%)
> 5 year	41	80	121 (37.7%)
Sign and symptom of low and/or high blood glucose
Yes	68	138	206 (64.2%)
No	48	67	115 (35.8%)
Routine eye and foot examination
Yes	38	75	113 (35.2%)
No	78	130	208 (64.8%)
Proper diet and meal plan follow-up
Yes	89	168	257 (80.1%)
No	27	37	64 (19.9%)
Fasting Blood Glucose (FBG) level
Controlled (70–130 mg/dl)	47	59	106 (33.0%)
Uncontrolled (>130 mg/dl)	69	146	215 (67.0%)
DM-related complication
Yes	20	46	66 (20.6%)
No	96	159	255 (79.4%)
If “yes”, the type of encountered complication
Nephropathy	3	13	16 (5.0%)
Neuropathy	4	3	7 (2.2%)
Retinopathy	4	13	17 (5.3%)
Diabetic ketoacidosis	5	5	10 (3.1%)
Coronary artery disease	1	1	2 (0.6%)
Foot ulcer	0	4	4 (1.2%)
Hyperosmolar hyperglycemic state	0	1	1 (0.3%)
Hypoglycemic	0	5	5 (1.6%)
Co-morbid conditions
Yes	25	51	76 (23.7%)
No	91	154	245 (76.3%)
If “yes”, type of encountered co-morbidity
Hypertension	24	40	64 (19.9%)
Congestive heart failure	1	6	7 (2.2%)
Asthma	0	1	1 (0.3%)
DM-related Admission
Yes	8	31	39 (12.1%)
No	108	174	282 (87.9%)
Number of prescribed medication per visit
1 drug	26	53	79 (24.6%)
2 drugs	43	63	106 (33.0%)
3 drugs	35	32	67 (20.9%)
>4 drugs	12	57	69 (21.5%)
Type of anti diabetic medication
Oral hypoglycemic agents	51	99	150 (46.7%)
Insulin	47	72	119 (37.1%)
Both	18	34	52 (16.2%)
Dose served on each visit
1 month dose	76	81	157 (48.9%)
2 month dose	29	88	117 (36.4%)
3 month dose and above	11	36	47 (14.6%)
Proper diet and meal plan follow-up
Yes	89	168	257 (80.1%)
No	27	37	64 (19.9%)
Presence of side effects
Yes	90	194	284 (88.5%)
No	26	11	37 (11.5%)
Counseling
Ever counseled
Yes	57	22	79 (24.6%)
No	59	183	242 (75.4%)
On each visit
Yes	44	122	166 (51.7%)
No	72	83	155 (48.3%)

Abbreviation: Mg/dl, milligram per deciliter.

Table 3 Frequency Distribution of Responses to Medication Adherence-Related Questions Among DM Patients at the General Hospitals in Eastern Zone of Tigrai, Ethiopia, from the 15th of March to the 15th of July 2019 (n=321)

Response to Adherence-Related Questions	Frequency	Percent (%)
The patient did not take his/her medication the previous day
Yes	167	52.0%
No	154	48.0%
The patient occasionally miss taking his/her medication
Yes	106	33.0%
No	215	67.0%
The patient misses using his/her medication in the past two weeks
Yes	64	19.9%
No	257	80.1%
The patient did not bring his/her medication with him/her during journey
Yes	89	27.7%
No	232	72.3%
The patient ever faced difficulty in remembering to consume all of his/her medications
Yes	113	35.2%
No	208	64.8%
The patient ever discontinued his/her medication without consulting his/her physician because he/she feels the disease has improved
Yes	72	25.2%
No	249	74.8%
The patient ever discontinued his/her medication without consulting his/her physician because he/she thinks the medication aggravates the disease
Yes	64	19.9%
No	257	80.1%
The patient ever felt annoyed to adhere to his/her treatment plan
Yes	99	30.8%
No	222	69.2%

Table 4 Logistic Regression Analysis of Non-Adherence to Medication and Associated Factors Among Patients with Diabetes Mellitus at the General Hospital of Eastern Zone of Tigrai, Ethiopia, from March 15th to the 15th of July 2019 (n=321)

Variables	COR, 95% CI	P-value	AOR, 95% CI	P-value
Monthly income
Less than 500 ETB	4.68 (2.51–8.74)	≤0.001	5.04(2.09–12.16)	≤0.001
Between 500–2000 ETB	3.19 (1.65–6.17)	0.001	2.59 (1.03–6.51)	0.043
Greater than 2000 ETB	1		1
Dose served
1 month	1		1
2 month	2.84 (1.68–4,80)	≤0.001	2.86 (1.38–5.95)	0.005
More than 3 month	3.07 (1.46–6.46)	0.003	4.31 (1.52–12.19)	0.006
Distance
Less than 4 KM	1		1
Between 4–24 KM	2.00 (1.13–3.55)	0.017	1.48 (0.66–3.28)	0.334
Greater than 24 KM	8.83(4.17–18.70)	≤0.001	10.09 (3.51–29.02)	≤0.001
Number of prescribed medication per visit
1 drug	1		1
2 drugs	0.72 (0.34–1.32)	0.72	0.65 (0.28–1.51)	0.320
3 drugs	0.45 (0.23–0.87)	0.19	0.38 (0.15–0.96)	0.42
>4 drugs	2.33 (1.07–5.08)	0.03	7.19 (2.17–23.82)	0.001
DM-related admission
Yes	0.41 (0.18–0.94)	0.034	0.25 (0.07–0.79)	0.018
No	1		1
Residence
Urban	1		1
Rural	2.42 (1.50–3.92)	≤0.001	1.22 (0.59–2.52)	0.586
Presence of side effects
Yes	5.09 (2.41–10.76)	≤0.001	4.51 (1.55–13.11)	0.006
No	1		1
Ever counseled
Yes	1		1
No	8.03 (4.53–14.25)	≤0.001	22.33 (9.27–53.81)	≤0.001

Notes: P-value = probability value, P ≤ 0.05 was taken as the level of significance.

Abbreviations: COR, crudes odd ratio; AOR, adjusted odd ratio; ETB, Ethiopian Birr; KM, kilometer; CI, confidence interval.