International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 11, No. 9, September 2021 | pp. 65–72

DOI: 10.46882/2021/IJMMS/110065

Original Research Article

Assessment of Medication Adherence Barriers and Glycemic Outcomes among Elderly Type 2 Diabetes Patients

Chidi O. Okafor¹, Amina J. Hassan², Samuel K. Appiah¹*

¹Department of Medicine, College of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.

²Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana.

Abstract:

Suboptimal medication adherence in elderly type 2 diabetes mellitus (T2DM) patients increases the risk of microvascular and macrovascular complications. This cross-sectional analytical study evaluated specific patient-centered barriers to medication adherence and their impact on glycemic outcomes in elderly patients. We enrolled 160 T2DM patients aged ≥ 65 years who were managed on oral antidiabetic agents for at least two years. Medication adherence was quantified using the 8-item Morisky Medication Adherence Scale (MMAS-8), and glycemic control was assessed via Glycated Hemoglobin (HbA1c), with values ≥ 7.5% defined as poor control in this demographic. The mean age of the participants was 71.4 ± 4.8 years, and 54.4% were female. Based on MMAS-8 scores, high adherence was found in only 28.1% of patients, moderate adherence in 41.3%, and low adherence in 30.6%. The overall prevalence of poor glycemic control was 62.5% (100/160), with a mean HbA1c of 8.2 ± 1.4% in the low adherence group. The most common self-reported barriers to adherence were polypharmacy ≥ 5 daily medications (68.5%), high out-of-pocket drug costs (58.0%), and forgetfulness or cognitive decline (42.5%). Multivariate logistic regression analysis showed that low adherence was strongly associated with a higher risk of poor glycemic control (OR = 3.6, 95% CI = 1.8–7.2, p < 0.001) and polypharmacy (OR = 2.4, p < 0.05). Poor medication adherence is common among elderly diabetic patients and is linked to polypharmacy and financial constraints. Targeted interventions, such as simplifying drug regimens and providing economic support, are essential to improve clinical outcomes.

Keywords: Type 2 Diabetes Mellitus, Elderly Patients, Medication Adherence, HbA1c, Polypharmacy, Financial Barriers

Manuscript Timeline: Received: May 20, 2021; Revised: June 28, 2021; Accepted: July 22, 2021; Published: September 16, 2021.

Citation: Okafor CO, Hassan AJ, Appiah SK. Assessment of Medication Adherence Barriers and Glycemic Outcomes among Elderly Type 2 Diabetes Patients. International Journal of Medicine and Medical Sciences, 2021, 11(9): 65–72. DOI: 10.46882/2021/IJMMS/110065

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