Treatment Adherence among Diabetes Mellitus Type II Patients at Ambulatory Clinics in the Western Region of Saudi Arabia: Descriptive Correlational Study

Abstract

Diabetes mellitus is a common problem in Saudi Arabia. Adherence to the pharmacological and lifestyle interventions regimens is essential for weight and glycaemic control, as well as prevention of co-morbidities. This study described the levels of treatment adherence among diabetes mellitus type II patients, explored the factors which influenced adherence and identified predictors of adherence. It was conducted in five ambulatory care clinics in the Western Region. The accessible population comprised diagnosed diabetes mellitus type II patients who received treatment at the ambulatory clinics. Persons aged ≥18 years and had been placed on medication and lifestyle intervention regimens at least six months prior to data collection, qualified for inclusion. The sample comprised 1,409 randomly selected participants. Participants completed a structured Arabic questionnaire, assisted by research assistants. The research assistants furthermore analysed the participants’ clinical records, using a structured checklist. Descriptive and inferential statistics were performed to quantify adherence, explore the relationships among variables and identify the predictors of adherence within the framework of the Health Belief Model. High prevalence of obesity and low prevalence of glycaemic control were found. Participants inadequately adhered to the medication and lifestyle intervention regimens, as well as blood glucose self-monitoring. The findings revealed various perceptual problems which might have contributed to inadequate adherence. The identified predictors of adherence indicated the essential requirements for health care interventions to improve treatment adherence. It is recommended that health education should address sociocultural in addition to biomedical matters to enhance the cultural congruency of interventions and ultimately adherence. Diabetes mellitus management aimed at achieving glycaemic and weight control and protection against co-morbidities requires health education, motivation and support targeted at medication and in particular lifestyle adherence.