Determinants of non-adherence to diabetic’s treatment among adult Diabetic patients in Gambella General Hospital

Abstract

Background: Diabetes mellitus (DM) is a disease recognized as a group of heterogeneous disorders with the common elements of hyperglycemia and glucose intolerance, due to insulin deficiency, impaired effectiveness of insulin action, or both. DM is a significant and growing health problem worldwide. Several studies conducted on the diabetes adherence in the country focus only on the magnitude of non-adherence without much consideration of determinant factors causing non-adherence. Objective: The objective of this research was to identify determinants of non-adherence to diabetic’s treatment among adult diabetic patients attending diabetic clinic in Gambella General Hospital. Methods and Materials: A facility based unmatched case- control study design was conducted from February to March, 2018 in the diabetic clinic in Gambella Hospital on 229 Type two adult diabetic patients (57 cases and 172 controls). Both cases and controls were selected by using systematic random sampling technique from patient register in the clinic. Pretested structured questionnaire was delivered in a face to face interview. The collected data were entered, cleaned and coded in EpiData 3.1 and exported to SPSS version 21 for analysis. Bivariate analysis for each independent variable with the outcome variable was performed using Chi- square test. All independent variables with p-value less than 0.25 were candidates for multivariable logistic regression model. Results: In the multivariate analysis, sex, educational level, forgetfulness, information on improper follow up consequences and distance to hospital were independently associated with non-adherence to DM treatment among adult diabetic patients who have been under follow up in the DM clinic in Gambella General Hospital. These were female respondents (AOR 6.295; CI 2.037-19.451) those who cannot read and write (AOR 8.532; CI 2.475-29.411), awareness of improper follow up consequences (AOR 3.661; CI 1.679-7.985), forgetfulness on taking pills (AOR 3.691; CI 1.706-7.986 ) and patient’s home distance to Hospital (AOR 0.242; CI 0.101- 0.580). Conclusion: This study came up with five independent factors that influenced non-adherence to DM treatment. Hence, routinely conducted patient education activities should directed on gender discrepancy on DM treatment. Moreover, those illiterate patients, information gap on DM consequences and difference on distance to hospital should be further studied including the three Zonal Hospitals in Gambella.