Determinants and patterns of medication adherence among individuals with type 2 diabetes mellitus

Abstract

Background: Medication adherence is a key determinant in the effective management of type 2 diabetes mellitus (T2DM). Poor adherence contributes to inadequate glycemic control, increased complications, and higher healthcare costs. This study aimed to assess patterns of medication adherence and associated factors among patients with T2DM in Bangladesh. Methods: A facility-based cross-sectional study was conducted among 412 adult patients with T2DM attending selected hospitals in Gazipur and Manikganj districts from September 2024 to March 2025. Participants were selected using simple random sampling. Data were collected through face-to-face interviews using a structured questionnaire, including the validated 8-item Morisky Medication Adherence Scale (MMAS-8). Descriptive statistics, Chi-square tests, and multivariable logistic regression analyses were performed using SPSS version 26. Results: Overall, 31.6% of participants demonstrated high adherence, 38.8% medium adherence, and 29.6% low adherence. Higher adherence was significantly associated with secondary or higher education (AOR: 2.14; 95% CI: 1.32-3.46), shorter duration of diabetes (<5 years) (AOR: 1.78; 95% CI: 1.10-2.89), good healthcare access (AOR: 2.67; 95% CI: 1.59-4.49), and living with family. Polypharmacy (AOR: 0.56; 95% CI: 0.34-0.91) and comorbidities (AOR: 0.63; 95% CI: 0.40-0.98) were negatively associated. Common barriers included forgetfulness (48.2%), financial constraints (33.5%), and lack of awareness (27.9%). Conclusions: Medication adherence among patients with T2DM was moderate and influenced by multiple factors. Interventions focusing on patient education, improved healthcare access, and family support are essential to enhance adherence and improve outcomes in Bangladesh.