ArticleThe Pan African medical journal2025
Medication non-adherence in patients with type 2 diabetes: a cross-sectional study in Morocco.
Article in The Pan African medical journal, 2025. 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
Introduction: medication non-adherence in patients with type 2 diabetes substantially contributes to poor glycemic control and increases the risk of complications. This study aimed to assess the prevalence of medication non-adherence and to identify its associated factors among Moroccan patients with type 2 diabetes. Methods: a cross-sectional study was conducted in the Endocrinology Department of Ibn Rochd University Hospital in Casablanca, Morocco. A total of 329 adult patients with type 2 diabetes were included. Medication adherence was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8). Bivariate logistic regression was performed to examine associations between non-adherence and socio-demographic, clinical, treatment, and behavioral-related factors. Results: among the participants, 52.6% exhibited low adherence, followed by 20.4% with moderate adherence and 27.1% with high adherence to antidiabetic medications. Socio-demographic characteristics, including age, gender, marital status, and education, showed no significant association with non-adherence. Several clinical and behavioral factors, however, were significantly related to adherence patterns. Higher odds of non-adherence were observed among patients who did not benefit from therapeutic education (p=0.009), individuals not performing self-monitoring of blood glucose (p<0.001), and those using phytotherapy (p=0.03). Additional determinants of poor adherence included higher out-of-pocket medication costs (p=0.043), drug shortages in health facilities (p=0.013), forgetfulness (p<0.001), absence of diabetic symptoms (p<0.001), and psychological barriers such as mistrust in physicians (p<0.001). Conversely, better adherence was associated with the combined use of oral antidiabetic drugs and insulin, follow-up with a general physician (p=0.036), dietary compliance (p<0.001), and regular physical activity (p=0.021). Conclusion: medication non-adherence remains highly prevalent among patients with type 2 diabetes. Our findings highlight the importance of strengthening therapeutic education, improving access to medications, and promoting healthy lifestyle behaviors to enhance adherence. Targeted interventions addressing both behavioral and healthcare system-related barriers are essential to improve long-term diabetes outcomes in the Moroccan context.
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