D. K. Yadav, S. Yadav, S. Karki, A. Mishra and A. Ghimire
ABSTRACT
Background: Diabetes mellitus (DM) is one of the growing non-communicable diseases in developing countries. The recent surveys by the International Diabetes Federation suggest that the South-East Asian region is home to more than 72 million adults with diabetes in 2013 and is expected to exceed 123 million in 2035. Adherence to medication and self-management practices both predicts the outcome of diabetes. The aim of this study is to assess adherence and self-management practices using the Morisky Medication Adherence Scale (MMAS-4) and diabetes self-management questionnaire (DSMQ), respectively.
Methods: A cross-sectional study was done in Letang Municipality of Morang District. Data were collected from 214 respondents. Face to face interview was done with the respondents who were under at least one oral hypoglycemic agents using a pre-structured questionnaire. The questionnaire consisted of MMAS-4 and DSMQ scale to assess adherence and self-management practices.
Result: More than half of the participants (56.9%) fell under 40–59 years, and 55% of the total participants were male. Seventy-nine percentage of the participants lived below the poverty line. Among the respondents, 95.4% were diagnosed with diabetes by the doctor and 59.6% of them were diagnosed in private clinics. Fifty-five percentage of the respondent were nonadherent to the drug. The majority of the respondents (87%) did not know about diabetic patients being prone to tuberculosis (TB). Only a small proportion (1.8%) of the respondents developed TB after DM. Adherence was found to increase with an increase in the age of the participants; literate participants living above the poverty line were found to have greater adherence than their counterparts. However, the association between different socio-demographic factors and medication adherence was nonsignificant. The DSMQ score of the participants ranged from 11 to 39. The mean DSMQ score was 23.51 with a standard deviation of 4.458.
Conclusion: Major proportions (55%) of participants were found to have poor adherence to their medication. Adherence was found to increase with an increase in the age of the participants; literate participants living above the poverty line were found to have greater adherence than their counterparts. However, the association of adherence was not found
to be statistically significant with the variables studied. There were poor self-management practices among the diabetic population.
Key words: Diabetes mellitus, drug adherence, self-management practice