Evaluation of Medication Adherence Among Diabetic Patients and Assessing the Role of Pharmacist Interventions in Improving Adherence

Abstract

Background; Diabetes, prevalent among Indians, presents significant management challenges and rising complications. Poor adherence leads to inadequate glycemic control and increased mortality risk.

Methods; A 9-month prospective observational study at a tertiary care hospital assessed medication adherence in 110 diabetic patients using the Morisky Medication Adherence Scale (MMAS). Patients were divided into Control and Intervention groups. The Control group received counseling and Patient Information Leaflets (PILs) after the initial evaluation and was then followed up after one month, effectively forming the Intervention group. The chi-square test analyzed adherence differences, and binary logistic regression identified predictors of adherence, with significance set at p < 0.05.

Result; The prevalence of low medication adherence was observed in 36% of patients, medium in 43%, and high in 31%. In the intervention group, adherence improved significantly: 20% low, 42% medium, and 48% high following pharmacist intervention (χ2=7.505, p= 0.023). Common barriers included forgetfulness, laziness, and polypharmacy. Predictors of low and medium adherence were rural living (low: AOR = 0.01, p = 0.019; medium: AOR = 0.12, p = 0.020), longer diabetes duration (low: AOR = 1.774, p = 0.031; medium: AOR = 1.42, p = 0.003), and comorbidities (low: AOR = 12.13, p = 0.041; medium: AOR = 2.04, p = 0.029). Additionally, low adherence was linked to unemployment and insulin therapy, while medium adherence was associated with alcohol consumption.

Conclusion; Pharmacist-led interventions significantly improved medication adherence. Enhanced communication between patients, doctors, and pharmacists is crucial for improving compliance, quality of life, and therapeutic outcomes.