Factors associated with medication adherence among people with type 2 diabetes in Indonesia: A multicenter cross-sectional study using structural equation modeling.
To disentangle the relationships of patient characteristics, diabetes knowledge, general beliefs about medication, specific beliefs about glucose-lowering medications and natural remedies, with adherence to glucose-lowering medication adherence.
This multicenter cross-sectional study was conducted across fifteen primary healthcare centers in Indonesia. Type 2 diabetes (T2D) patients (≥18 years) who consented to participate were included. Assessment tools included the adapted Diabetes Knowledge Questionnaire (DKQ), Beliefs about Medications Questionnaire (BMQ), and Medication Adherence Report Scale-5 (MARS-5). Structural equation modeling was employed.
A total of 328 patients with T2D participated (mean age 60.6 ± 8.9 years; diabetes duration 7.1 ± 6.2 years; 74.4% female). The final model showed that experiencing side effects from glucose-lowering medication was associated with lower medication adherence (β = -0.234), whereas educational level showed an association, with only medium-level education being associated with higher adherence (β = 0.135). General beliefs about medication overuse (β = -0.230) and specific beliefs about the necessity of glucose-lowering medication (β = 0.195) were associated with adherence during model selection. General beliefs about medication overuse and specific beliefs about medication necessity were positively correlated (β = 0.413). Diabetes knowledge and natural remedy beliefs were not associated with medication adherence.
General and specific beliefs about medications, as well as experiences of side effects, were associated with adherence to glucose-lowering medications. Interventions should focus on addressing these beliefs and managing side effects. Given the relationships between such factors, personalized approaches may be necessary to improve adherence.
This multicenter cross-sectional study was conducted across fifteen primary healthcare centers in Indonesia. Type 2 diabetes (T2D) patients (≥18 years) who consented to participate were included. Assessment tools included the adapted Diabetes Knowledge Questionnaire (DKQ), Beliefs about Medications Questionnaire (BMQ), and Medication Adherence Report Scale-5 (MARS-5). Structural equation modeling was employed.
A total of 328 patients with T2D participated (mean age 60.6 ± 8.9 years; diabetes duration 7.1 ± 6.2 years; 74.4% female). The final model showed that experiencing side effects from glucose-lowering medication was associated with lower medication adherence (β = -0.234), whereas educational level showed an association, with only medium-level education being associated with higher adherence (β = 0.135). General beliefs about medication overuse (β = -0.230) and specific beliefs about the necessity of glucose-lowering medication (β = 0.195) were associated with adherence during model selection. General beliefs about medication overuse and specific beliefs about medication necessity were positively correlated (β = 0.413). Diabetes knowledge and natural remedy beliefs were not associated with medication adherence.
General and specific beliefs about medications, as well as experiences of side effects, were associated with adherence to glucose-lowering medications. Interventions should focus on addressing these beliefs and managing side effects. Given the relationships between such factors, personalized approaches may be necessary to improve adherence.
Authors
Cahyaningsih Cahyaningsih, Rokhman Rokhman, Maziyyah Maziyyah, Mubarik Mubarik, Denig Denig, Taxis Taxis
View on Pubmed