Factors affecting adherence to Insulin Therapy among patients with type 2 Diabetes mellitus in a teaching hospital, Sri Lanka

Abstract

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Globally diabetes is a major public health problem. The prevalence of diabetes in Asian countries has been increasing over the past few decades. Life style modification strategies such as diet control and regular exercise are the major considerations of diabetes. When these strategies are unable to control glycemic levels, pharmacological management need to be used. Insulin therapy is an important component of pharmacological management of type 2 diabetes mellitus (T2DM). However, there is limited data available on factors affecting adherence to insulin therapy among patients with T2DM in Sri Lanka. Therefore the aim of this study was to determine factors that affecting adherence to insulin therapy among patients with T2DM in a tertiary care hospital, Sri Lanka. A descriptive cross sectional study was conducted among purposively selected patients with T2DM(n=252). A pretested, interviewer administered questionnaire and eight item Morisky medication adherence scale were used to collect data. Descriptive statistics were used to analyze the data. Ethical approval was obtained from the Ethics Review Committees of Faculty of Medical Sciences, University of Sri Jayawardenapura and Colombo South Teaching Hospital. Findings of this study revealed that majority of the participants (70.6%) were diagnosed with T2DM for 2- 15 years. Most of the participants (85.7%) have been taking insulin as their medication treatment for 1-5 years. The overall adherence rate was found to be 107(42.5%). Among adherent participants 68(63.6%) were males and 39 (36.4%) were females. The majority of the participants 89 (83.2%) are aware of complications. Ninety one (85%) participants did not have financial problems to buy medication. In addition, 89(83.2%) participants do not have stress or emotional problems, 35(32.7%) have not physical disability or other chronic diseases, while 66(61.7%) do not think taken insulin at same time every day as a challenge, 76(71%) take meals on time. Adherence to insulin therapy among participants was less due to inadequate knowledge and awareness about the complications. Patients’ knowledge regarding diabetes management could improve their medication adherence, therefore, health care providers should provide more effective health education to maintain and enhance their adherence to insulin therapy.