An Exploratory Study on the Adherence to Therapies in Type-2 Diabetes Mellitus Patients in Thimphu, Bhutan.

Abstract

Objectives: To examine the prevalence of adherence to recommended medications and lifestyle

guidance among the Type-2 diabetic patients and to determine the factors influencing non- adherence behaviors.

Methodology: A hospital based cross sectional study was performed among patients with type 2 diabetes mellitus in Thimphu. A semi-structured survey questionnaire was used for data collection through face-to-face interview. The questions were based on their socio-demographic status, their diet, physical activities and medication compliance behavior. Results: Among the 201 participants, 57.0% belonged to middle age group (54-76 yrs.), 55.2% were female, 49.3% were unemployed and more than half of the participants (59.7%) were uneducated. This study found that 47.3% of the participants had low adherence to treatment recommendation. Participants with high education (OR: 9.647, 95% Confidence Interval (CI): 1.561-59.637) and family history of diabetes (OR: 8.000, 95% CI: 1.252-51.137) were found to have more chance of being adherent after adjusting for possible confounding variables. Tobacco and alcohol usage were also significant in causing non-adherence behaviors (OR: 0.369, 95% CI: 0.191-0.714 and OR: 0.097, 95% CI: 0.030-0.314 respectively). Conclusion: This study rejects the null hypothesis (i.e. high prevalence of non-adherence behaviors among T2D patients) and found that adherence to treatment recommendations among Type-2 Diabetic patients are relatively higher (52.7%) as compare to non-adherent cases (47.3%). Further research is needed in other parts of the country to understand the treatment adherence behaviors and to identity factors causing non-adherence. Educating on the importance of adherence to therapies is also crucial.