ArticleMaedica2026
Medication Adherence and Its Determinants in Patients with Type 2 Diabetes Mellitus Attending an Internal Medicine Outpatient Department.
Article in Maedica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Medication adherence remains a central element in achieving optimal glycemic control in type 2 diabetes mellitus. Many patients struggle to follow prescribed therapy, leading to early metabolic deterioration and a higher burden of complications. Understanding the factors that shape adherence in routine clinical settings can help guide targeted interventions. Materials and methods: A hospital-based observational study was conducted in the Internal Medicine Outpatient Department of the Dominica China Friendship Hospital, Dominica, between August 2024 and January 2025. Adults diagnosed with type 2 diabetes mellitus and on treatment for at least six months were eligible. A total of 420 patients were enrolled. Medication adherence was measured using the eight-item Morisky medication adherence scale (MMAS-8). Sociodemographic, clinical and behavioral characteristics were documented through structured interviews and medical records. Data were analyzed using chi-square tests to assess associations and multivariate logistic regression was applied to identify independent predictors of adherence. Results: Participants had a mean age of 54.6 ± 10.8 years, with males comprising 58.3% of the cohort. According to MMAS-8 scoring, 29.3% demonstrated high adherence, 41.9% moderate adherence and 28.8% low adherence (mean score 6.21 ± 1.54). Forgetfulness, discontinuation of therapy after symptomatic improvement and financial constraints were the most commonly reported barriers. On multivariable analysis, higher education, simplified drug regimen, regular follow-up and good glycemic control emerged as independent predictors of good adherence. Participants with high adherence exhibited significantly lower mean HbA1c levels compared with poorly adherent individuals (6.8 ± 0.9% vs 8.3 ± 1.1%, p < 0.001). Conclusion: Medication adherence was suboptimal in a substantial proportion of adults with type 2 diabetes mellitus. Interventions that strengthen diabetes education, reduce regimen complexity and promote structured follow-up may improve adherence and support better glycemic control.
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