Prescription Pattern and Medication Adherence of Antidiabetic Agents in Diabetic Patients at a Tertiary Care Hospital: A Prospective Observational Study

Abstract

Background: In India, diabetes mellitus (DM) is a major healthcare concern, and patient adherence and sensible prescribing are essential to its best management. However, integrated data on prescription patterns and medication adherence in clinical settings, particularly in South India, remains limited.

Aim: This study sought to determine the degree and predictors of medication adherence among diabetic patients as well as the prescription trends for antidiabetic medications.

Methods: At a tertiary care hospital in Erode, Tamil Nadu, a six-month prospective observational study was carried out. Data from 130 diabetic patients were collected using a structured form comprising prescription details and the validated 8item Morisky Medication Adherence Scale (MMAS8). Adherence was classified as poor (score <6), medium (scoring = 67), or high (score = 8). Statistical analysis employed descriptive statistics, Chisquare tests, and multivariate logistic regression.

Results: The average age was 52.4±10.8 years, and 55.4% of the population was male. Type 2 diabetes was prevalent (94.6%). Metformin was the most prescribed antidiabetic agent (78.5%), followed by sulfonylureas (49.2%); 53.1% received combination therapy. Comorbidities were common, led by hypertension (51.5%). Based on MMAS8, 29.2%, 41.5%, and 29.2% demonstrated high, medium, and low adherence, respectively. The primary reason for nonadherence was forgetfulness (59.8%). Multivariate analysis identified age ≥60 years (AOR=1.96; 95% CI:1.01–3.82) and diabetes duration >10 years (AOR=2.18; 95% CI:1.02–4.68) as significant independent predictors of low adherence.

Conclusion: While metforminbased regimens align with guidelines, suboptimal medication adherence, particularly among elderly patients and those with longer disease duration, remains a major concern. Targeted interventions focusing on these groups through education, regimen simplification, and regular adherence monitoring are crucial to improving glycemic outcomes.