Evaluation of Adherence to Diabetic Treatment in Northern Region of United Arab Emirates

Purpose: To determine medication adherence and predictors of suboptimal adherence in patients with diabetes type 2, and to address the factors that are associated with treatment non-adherence in Northern Region of United Arab Emirates (UAE).
Methods: This cross-sectional study involved 200 type 2 diabetes mellitus (T2DM) patients randomly selected from outpatient clinics in Northern Region, UAE. Special questionnaire form have been prepared to assess the level of adherence then filled in through direct interviewing with the patients. The adherence level score was calculated based on total summation of items related to good adherence and accordingly participants’ scores of 90 % or more were considered adherent and who achieved less than 90 % were non-adherent.
Results: Only 120 (60 %) of the patients were adherent. Factors that are associated with non- adherence were :age ≥ 50 (OR = 1.8, 95 % CI= 1.02 - 3.19), lower education level (OR = 0.17, 95 % CI = 0.09 - 0.31), lack of health insurance (OR = 21, 95 % CI = 9.62 - 45.85), forgetfulness (OR= 0.29, CI = 0.13 - 0.61), co-morbidities (OR = 0.24, 95 % CI = 0.11 - 0.51), > 6.5 % HbA1C (OR = 7.22,95 % CI = 3.69 - 14.14); longer time since last visit to clinic (OR = 14, 95 % CI = 6.52 - 30.04); increased medication cost (OR = 30, 95 % CI = 11.2 - 80.1); and unawareness (lack of awareness) of physician instructions (OR = 7.22, 95 % CI = 3.7 - 14.1).
Conclusion: Adherence to diabetes treatment was quite poor among participants. Glycemic control could be improved through early identification and incentives for adherence behaviors which can be supported using a counseling approach of communication with the patients by healthcare professionals before applying any individual patient management plan.

Keywords
Medication adherence; Type 2 diabetes; Antidiabetic; Predictors; United Arab Emirates