Affiliations: Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
Corresponding author: Rasoul Tabari-Khomeiran, Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran. Address: Nursing & Midwifery Faculty, Danshjoo Rd. Rasht, Postal code: 41469-39841, Iran. Tel.: +981333555058/+98133355056; Fax: +981333550097; E-mails: [email protected] and [email protected].
Abstract: BACKGROUND:Type 2 diabetes is a common chronic disease in developing countries. It has widespread effects on many aspects of the lives of patients and their families, so health care systems should prioritize the management of diabetes. Blood glucose control and prevention of complications are the primary goals of diabetes care. Achievement is possible when the patients adhere to the treatment regimen, although several factors are known to affect the adherence. OBJECTIVE:The aim of this study was to evaluate the adherence to treatment and identify a number of its predictive factors in patients with diabetes in northern Iran. METHODS:In this cross-sectional analytical study, 266 patients with type 2 diabetes were selected through convenience sampling. The data-gathering tool was a self-administered questionnaire containing questions about personal and social characteristics of patients, as well as a 40-item questionnaire to measure patients’ adherence to treatment. The questionnaire consisted of seven domains: (i) making the effort for treatment, (ii) intention to take the treatment, (iii) adaptability, (iv) integrating illness into life, (v) sticking to the treatment, (vi) commitment to treatment, and (vii) indecisiveness about applying treatment. Data collection lasted from first week of November 2017 to the first week of January 2018. RESULTS:Most subjects were adherent to treatment. The highest adherence was in “commitment to treatment,” subdomain and the lowest adherence was in “adaptability.” In univariate analysis age, educational achievement, occupation, Body Mass Index (BMI), duration of diabetes, searching information about diabetes, and comorbidities were significantly related to adherence to treatment. The results of multivariate analysis also showed that patients who had normal BMI, academic education, searching behaviour for information, longer history of diabetes, and more comorbidities were more likely to be adherent. CONCLUSION:This study revealed a number of predictive factors of adherence to treatment in patients with diabetes. This may inform the health policy makers to take appropriate actions for promoting treatment adherence among patients.
Keywords: Type 2 diabetes, adherence to treatment, predictive factors