An evaluation of patients’ adherence with hypoglycemic medications among Papua New Guineans with type 2 diabetes: influencing factors

Figures & data

Table 1 Participant characteristics

Variable	Frequencya N (%)	Nonadherentb %	P-valuec
Sex			0.9004
Female	222 (63.2)	59.0
Male	129 (36.8)	59.7
Age group			0.0241
≤50	114 (33.7)	65.8
51–60	132 (39.1)	62.1
≥61	92 (27.2)	47.8
Area of residence			0.3320
Urban	199 (56.9)	61.3
Peri-urban	67 (19.1)	62.7
Rural village	70 (20.0)	52.9
Outside province	14 (4.0)	42.9
Number of hypoglycemic agents			0.1702
1	187 (54.0)	55.6
2 or 3	159 (46.0)	62.9
Number of comedications			0.3530
0	131 (37.3)	64.1
1	119 (33.9)	59.7
2	60 (17.1)	53.3
≥3	41 (11.7)	51.2
A1C at baseline			0.0105
≤7% (53.0 mmol/mol)	63 (18.9)	55.6
>7%–10% (85.8 mmol/mol)	164 (49.1)	53.1
>10%	107 (32.0)	71.0

Notes: N=351.

a May not add up to the total because of missing data.

b Numbers in the “Nonadherent” column show the percentage of each row who were not completely (100%) adherent to their medications.

c P-values are calculated from the chi-square statistic.

Abbreviation: A1C, glycated hemoglobin.

Table 2 Multivariate logistic regression with nonadherence as the dependent variable

Variable	Nonadherence n/N (%)	Odds ratio	95% confidence interval	P-value
100% adherence
Age
>60	51/105 (48.6)	1 (reference)
≤60	157/246 (63.8)	1.87	1.18–2.97	0.0081
95% adherence
Age
>60	27/104 (26.0)	1 (reference)
≤60	77/241 (32.0)	1.34	0.80–2.24	0.2669
90% adherence
Age
>60	13/104 (12.5)	1 (reference)
≤60	54/241 (22.4)	2.02	1.05–3.89	0.0353
80% adherence
Age
>60	9/104 (8.7)	1 (reference)
≤60	38/241 (15.8)	1.98	0.92–4.25	0.0815

Table 3 Logistic regression analysis: the influence of medication adherence on abnormally high A1C

Adherence level	A1C >10% n/N (%)a	Odds ratio	95% confidence interval	P-value
100%	31/136 (22.8)	1 (reference)
95%–99%	38/92 (41.3)	2.4	1.3 to 4.2	0.0032
90%–94%	12/36 (33.3)	1.7	0.8 to 3.8	0.1970
80%–89%	6/19 (31.6)	1.6	0.5 to 4.5	0.4030
<80%	19/45 (42.2)	2.5	1.2 to 5.1	0.0129

Notes: Each participant was classified into their level of adherence, and the dependent variable was high A1C (A1C >10% [85.8 mmol/mol]).

a The column showing “n/N (%)” shows the number of people (and percentage) within the given adherence level who have high A1C.

Abbreviation: A1C, glycated hemoglobin.

Table 4 Identified number of factors contributing to nonadherence

Individual factors influencing adherence	Percentagea n (%) (N=207)
Patient-related factors
Forgetting	74 (35.7%)
Had script but did not refill	67 (32.4%)
Refused to take hypoglycemic medications	22 (10.6%)
Others (Travel, transport costs to and from remote villages to the city, alternative therapy, lack of psychosocial support)	15 (7.2%)
Medication related factors
Medication cost	15 (7.2%)
Perceived adverse effects	12 (5.8%)
Health care-system-related factors
Access to and from remote villages	5 (2.4%)
Inconsistent medical supplies in public hospital	7 (3.4%)
Access to diabetes clinic for repeat scripts	33 (15.9%)
Prescriber factors
Insufficient information about disease and medications	4 (1.9%)
Other reasons
Theft of bag containing medications	2 (1.0%)

Notes:

a Total percentage >100% because some participants gave more than one reason.