Adherence to anti-diabetic medication and associated factors among Type 2 Diabetic patients in Nsambya, Lubaga and Mengo Hospitals in Kampala

Abstract

Introduction: Over 4.6 % of the Ugandan population aged 20-70 is living with diabetes with majority living in urban areas like Kampala. Type 2 Diabetes (T2D) is associated with complications like heart disease, stroke, kidney problems, and cancers if not managed or treated. Preventing these complications and having better treatment outcomes requires good adherence to treatment. However, there is limited information on adherence to anti-diabetic treatment among patients in private health facilities yet majority of the patients in urban areas access treatment in private facilities. Main Objective: To assess adherence to anti-diabetic treatment and associated factors among diabetic patients in Mengo, Lubaga and Nsambya hospitals in Kampala, Uganda. Methods: The study employed a cross sectional quantitative study design. Data was collected among 459 consecutively sampled type 2 diabetic patients receiving care in Mengo, Lubaga and Nsambya hospitals using semi structured questionnaires embedded on the kobo collect app on android phones. The collected data was cleaned in excel 2016, and analyzed in STATA version 15 statistical software. Descriptive analyses were conducted and presented as percentages in tables. Association between the adherence to anti-diabetic medication and independent factors was determined using modified Poisson regression at bivariate and multivariate analysis. Results: About 54.5% (95% CI: 26.7-79.7) of the patients adhered to antidiabetic treatment. Using insulin as type of medication (PR-0.53, 95%CI: 0.45-0.81), being reminded by family to take medicines (PR-0.67, 95%CI: 0.48-0.94), was negatively associated with adherence to anti diabetic medication. Additionally, not experiencing side effects while using anti diabetic medication (PR-1.34, 95%CI: 1.03-2.05), was associated to anti-diabetic medication. Conclusion: The study revealed that adherence to antidiabetic medication was suboptimal in private health facilities in Kampala. This low adherence level is associated to insulin use, experiencing side effects, drug unavailability, having a family member with diabetes and reliance on a family member for reminders. Therefore, strategies such as improved stock taking in health facilities and health education of both patients and caretakers on diabetes should be strengthened at these facilities to improve adherence.