Medication adherence among patients with type 2 diabetes

A mixed methods study

Nouf M. Aloudah, Neil W. Scott, Hisham S. Aljadhey, Vera Araujo-Soares, Khalid A. Alrubeaan, Margaret C. Watson

Research output: Contribution to journalArticle

Abstract

Objective Oral hypoglycemic agents (OHAs) are highly effective in managing Type 2 diabetes if taken appropriately. This study assessed adherence to OHAs among patients with Type 2 diabetes and explored factors associated with adherence behaviour. Research design and methods Mixed methods were used comprising a cross-sectional study using the Arabic version of the Morisky Medication Adherence Scale followed by semi-structured interviews using the Theoretical Domain Framework to explore key determinants of adherence. Results The cross-sectional study included 395 patients of whom 40% achieved a high level of OHA adherence. Lower adherence was associated with younger age (Odds Ratio (OR) 1.084; 95% CI 1.056 to 1.112), higher numbers of non-OHAs (OR 0.848; 95% CI 0.728 to 0.986) and higher HbA1c levels (OR 0.808; 95% CI 0.691 to 0.943). Semi structured interviews based on the Theoretical Domain Framework were completed with 20 patients and identified a wide range of factors potentially associated with OHA adherence, particularly behavioural related factors (e.g. scheduling medication intake, ability to develop a habitual behaviour), social influences (e.g. acting as a role model, the effect of family support), and gaps in knowledge about diabetes and its management with OHAs. Conclusions This unique mixed-methods study has highlighted possible reasons for the low levels of OHA adherence in this patient population. Whilst the theoretically-derived determinants of behaviour illustrate the complexities associated with OHA adherence, they also provide a robust underpinning for future intervention(s) development to improve adherence and maxi-mise patient health outcomes.

Original languageEnglish
Article numbere0207583
JournalPLoS ONE
Volume13
Issue number12
DOIs
Publication statusPublished - 1 Dec 2018

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Aloudah, N. M., Scott, N. W., Aljadhey, H. S., Araujo-Soares, V., Alrubeaan, K. A., & Watson, M. C. (2018). Medication adherence among patients with type 2 diabetes: A mixed methods study. PLoS ONE, 13(12), [e0207583]. https://doi.org/10.1371/journal.pone.0207583

Medication adherence among patients with type 2 diabetes : A mixed methods study. / Aloudah, Nouf M.; Scott, Neil W.; Aljadhey, Hisham S.; Araujo-Soares, Vera; Alrubeaan, Khalid A.; Watson, Margaret C.

In: PLoS ONE, Vol. 13, No. 12, e0207583, 01.12.2018.

Research output: Contribution to journalArticle

Aloudah, NM, Scott, NW, Aljadhey, HS, Araujo-Soares, V, Alrubeaan, KA & Watson, MC 2018, 'Medication adherence among patients with type 2 diabetes: A mixed methods study', PLoS ONE, vol. 13, no. 12, e0207583. https://doi.org/10.1371/journal.pone.0207583
Aloudah NM, Scott NW, Aljadhey HS, Araujo-Soares V, Alrubeaan KA, Watson MC. Medication adherence among patients with type 2 diabetes: A mixed methods study. PLoS ONE. 2018 Dec 1;13(12). e0207583. https://doi.org/10.1371/journal.pone.0207583
Aloudah, Nouf M. ; Scott, Neil W. ; Aljadhey, Hisham S. ; Araujo-Soares, Vera ; Alrubeaan, Khalid A. ; Watson, Margaret C. / Medication adherence among patients with type 2 diabetes : A mixed methods study. In: PLoS ONE. 2018 ; Vol. 13, No. 12.
@article{5607de1c55704255830e20014e38940e,
title = "Medication adherence among patients with type 2 diabetes: A mixed methods study",
abstract = "Objective Oral hypoglycemic agents (OHAs) are highly effective in managing Type 2 diabetes if taken appropriately. This study assessed adherence to OHAs among patients with Type 2 diabetes and explored factors associated with adherence behaviour. Research design and methods Mixed methods were used comprising a cross-sectional study using the Arabic version of the Morisky Medication Adherence Scale followed by semi-structured interviews using the Theoretical Domain Framework to explore key determinants of adherence. Results The cross-sectional study included 395 patients of whom 40{\%} achieved a high level of OHA adherence. Lower adherence was associated with younger age (Odds Ratio (OR) 1.084; 95{\%} CI 1.056 to 1.112), higher numbers of non-OHAs (OR 0.848; 95{\%} CI 0.728 to 0.986) and higher HbA1c levels (OR 0.808; 95{\%} CI 0.691 to 0.943). Semi structured interviews based on the Theoretical Domain Framework were completed with 20 patients and identified a wide range of factors potentially associated with OHA adherence, particularly behavioural related factors (e.g. scheduling medication intake, ability to develop a habitual behaviour), social influences (e.g. acting as a role model, the effect of family support), and gaps in knowledge about diabetes and its management with OHAs. Conclusions This unique mixed-methods study has highlighted possible reasons for the low levels of OHA adherence in this patient population. Whilst the theoretically-derived determinants of behaviour illustrate the complexities associated with OHA adherence, they also provide a robust underpinning for future intervention(s) development to improve adherence and maxi-mise patient health outcomes.",
author = "Aloudah, {Nouf M.} and Scott, {Neil W.} and Aljadhey, {Hisham S.} and Vera Araujo-Soares and Alrubeaan, {Khalid A.} and Watson, {Margaret C.}",
year = "2018",
month = "12",
day = "1",
doi = "10.1371/journal.pone.0207583",
language = "English",
volume = "13",
journal = "PLoS ONE",
issn = "1932-6203",
publisher = "Public Library of Science (PLOS)",
number = "12",

}

TY - JOUR

T1 - Medication adherence among patients with type 2 diabetes

T2 - A mixed methods study

AU - Aloudah, Nouf M.

AU - Scott, Neil W.

AU - Aljadhey, Hisham S.

AU - Araujo-Soares, Vera

AU - Alrubeaan, Khalid A.

AU - Watson, Margaret C.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Objective Oral hypoglycemic agents (OHAs) are highly effective in managing Type 2 diabetes if taken appropriately. This study assessed adherence to OHAs among patients with Type 2 diabetes and explored factors associated with adherence behaviour. Research design and methods Mixed methods were used comprising a cross-sectional study using the Arabic version of the Morisky Medication Adherence Scale followed by semi-structured interviews using the Theoretical Domain Framework to explore key determinants of adherence. Results The cross-sectional study included 395 patients of whom 40% achieved a high level of OHA adherence. Lower adherence was associated with younger age (Odds Ratio (OR) 1.084; 95% CI 1.056 to 1.112), higher numbers of non-OHAs (OR 0.848; 95% CI 0.728 to 0.986) and higher HbA1c levels (OR 0.808; 95% CI 0.691 to 0.943). Semi structured interviews based on the Theoretical Domain Framework were completed with 20 patients and identified a wide range of factors potentially associated with OHA adherence, particularly behavioural related factors (e.g. scheduling medication intake, ability to develop a habitual behaviour), social influences (e.g. acting as a role model, the effect of family support), and gaps in knowledge about diabetes and its management with OHAs. Conclusions This unique mixed-methods study has highlighted possible reasons for the low levels of OHA adherence in this patient population. Whilst the theoretically-derived determinants of behaviour illustrate the complexities associated with OHA adherence, they also provide a robust underpinning for future intervention(s) development to improve adherence and maxi-mise patient health outcomes.

AB - Objective Oral hypoglycemic agents (OHAs) are highly effective in managing Type 2 diabetes if taken appropriately. This study assessed adherence to OHAs among patients with Type 2 diabetes and explored factors associated with adherence behaviour. Research design and methods Mixed methods were used comprising a cross-sectional study using the Arabic version of the Morisky Medication Adherence Scale followed by semi-structured interviews using the Theoretical Domain Framework to explore key determinants of adherence. Results The cross-sectional study included 395 patients of whom 40% achieved a high level of OHA adherence. Lower adherence was associated with younger age (Odds Ratio (OR) 1.084; 95% CI 1.056 to 1.112), higher numbers of non-OHAs (OR 0.848; 95% CI 0.728 to 0.986) and higher HbA1c levels (OR 0.808; 95% CI 0.691 to 0.943). Semi structured interviews based on the Theoretical Domain Framework were completed with 20 patients and identified a wide range of factors potentially associated with OHA adherence, particularly behavioural related factors (e.g. scheduling medication intake, ability to develop a habitual behaviour), social influences (e.g. acting as a role model, the effect of family support), and gaps in knowledge about diabetes and its management with OHAs. Conclusions This unique mixed-methods study has highlighted possible reasons for the low levels of OHA adherence in this patient population. Whilst the theoretically-derived determinants of behaviour illustrate the complexities associated with OHA adherence, they also provide a robust underpinning for future intervention(s) development to improve adherence and maxi-mise patient health outcomes.

UR - http://www.scopus.com/inward/record.url?scp=85058414261&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0207583

DO - 10.1371/journal.pone.0207583

M3 - Article

VL - 13

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 12

M1 - e0207583

ER -