Objective:
The overall goal of the study was to evaluate the probable reasons
for patients’ nonadherence to prescribed oral hypoglycemic medications
in an ambulatory care setting in Nigeria with a view to identifying
points for necessary intervention to improve adherence and treatment
outcomes. Also, the recommended non-drug management options for
diabetes patients with emphasis on self monitoring of blood glucose
were assessed.
Methods: A cross-sectional study was conducted at a 200-bed secondary
health care facility in Southwestern Nigeria between 2nd April
and 31st May 2008. Copies of pre-tested questionnaire were administered
directly to 121 ambulatory patients with type 2 diabetes at the
study site. Information on socio-demographic characteristic, probable
barriers that affect adherence to prescribed oral hypoglycemic
medications, non-drug treatment options for diabetes, and patients’
self management efforts were obtained. Descriptive and chi-square
statistics were used to evaluate the distribution of respondents’
opinion.
Results: The response rate was almost 100%. The commonly cited
intentional nonadherence practice included dose omission (70.2%).
Almost 50% respondents were fed up with daily ingestion of drugs
and 19.8% were inconvenienced with taking medications outside
home and gave these as reasons for the dose omission. Forgetfulness
(49.6%) and high cost of medication (35.5%) were mentioned as
major non-intentional reasons for nonadherence. Aside oral medications,
82.6% and 95.0% of respondents respectively, reported moderate
exercise and dietary restrictions as part of the prescribed treatment
modalities. More than two third of respondents (81.8%) had never
monitored blood glucose by themselves. Significant association
exist between sex, occupation and patients’ tendencies to forget
doses of prescribed oral medications (p<0.05).
Conclusion: Nonadherence behaviors among ambulatory patients with
type 2 diabetes occur mostly, as omission and forgetfulness of
doses of medication. Efforts are needed to increase the medication
adherence and self management practices of these patients in Nigeria
so they can realize the full benefits of prescribed therapies.
