Non-adherence to diabetes treatment at Mulago Hospital in Uganda: prevalence and associated factors
Background: Non-adherence to diabetes treatment leads to poor glucose control and increases the risk of disease complications. The prevalence and factors associated with non-adherence in resource limited settings should be determined so as to lower the impact of a disease that is on the increase, on the health systems which are already overburdened with communicable diseases. Objectives: To determine the prevalence and factors associated with non-adherence to diabetes treatment. Methods: A cross sectional study was carried out from February to April 2004 in Mulago Hospital, Uganda. The participants were 402 type 1 and 2 diabetic patients selected from the outpatients' diabetic clinic using systematic sampling. They were aged 18 years and above, had been taking diabetes treatment for at least one month and gave informed consent to participate. Non-adherence was assessed using patients' self reports. Results: The prevalence of non-adherence was 28.9% (n = 116, 95%CI = 24.5 – 33.3%). Factors that were independently associated with non-adherence were: female gender (OR = 2.9, 95%CI = 1.4 – 6.3), not understanding the drug regimen well (OR = 4.0, 95%CI = 1.0 – 16.3), affording only some or none of prescribed drugs (OR = 3.7, 95%CI = 1.8 – 7.6) and longer time since last since last visit to a health worker (OR = 7.3, 95%CI = 2.7 – 19.9). Conclusions: Adherence to diabetic treatment was suboptimal. There is need to improve it through strategies helping patients understand their drug regimens, always availing drugs in the hospital so that they do not have to buy them and giving shorter time between visits to health worker. Further studies should be done to find out why females were not adhering to treatment so as to improve their adherence.
African Health Science Vol. 8 (2) 2008: pp. 67-73
While African Health Sciences has been freely accessible online there have been questions on whether it is Open Access or not. We wish to clearly state that indeed African Health Sciences is Open Access. There are key issues regarding Open Access needing clarification for avoidance of doubt:
- 1. Henceforth, papers in African Health Sciences will be published under the CC BY (Creative Commons Attribution License) 4.0 International. See details on https://creativecomons.org/)
- 2. The copyright owners or the authors grant the 3rd party (perpetually and in advance) the right to disseminate, reproduce, or use the research papers in part or in full, format/medium as long as:
- No substantive errors are introduced in the process
- Attribution of authorship and correct citation details are given
- The referencing details are not changed.
Should the papers be reproduced in part, this must be clearly stated.
- 3. The papers will be freely and universally accessible online in an easily readable format such as XML in at least one widely recognized open access repository such as PUBMED CENTRAL.
B. ABRIDGED LICENCE AGREEMENT BETWEEN AUTHORS AND African Health Sciences
I submitted my manuscript to African Health Sciences and would like to affirm that:
1.0 I am authorized by my co-authors to enter into these arrangements.
2.0 I guarantee, on behalf of self and co-authors:
- That the paper is original, and has not been published in any other peer-reviewed journal; nor is it under consideration by other journal (s). It does not infringe existing copyright or any other person’s rights
- That we are/I am the sole author(s) of the paper and with authority to enter into this agreement. My granting rights to African Health Sciences is not in breach of any other obligation
- That the paper contains nothing unlawful, or libelous. Nor anything that would constitute a breach of contract, confidence or commitment given to secrecy, if published
- That I/we have taken care to ensure the integrity of the article.