MEDICATION REGIMEN COMPLEXITY AND ITS ASSOCATION WITH THE CLINICAL OUTCOMES AND ADHERENCE AMONG PATIENTS WITH TYPE II DIABETIES AT DEBRE BIRHAN COMPREHENSIVE AND SPACALIZED HOSPITAL, DEBRE BIRHAN, ETHIOPIA.

Abstract

Abstract Introduction: Type II diabetes (TIIDM) is a metabolic syndrome requiring incessant medical care. Its metabolic pathways range from decreased insulin secretion to insulin insensitivity. Attaining glycaemic control in patients with TIIDM usually requires more complicated medication regimens. Increased medication regimen complexity (MRC) negatively impacts medication adherence and clinical outcomes Objectives: The aim of this study was to assess medication regimen complexity and its association with glycaemic control, medication adherence, and quality of life among TIIDM patients at Debre Birhan compressive and specialized hospital (DBCSH). Methods: A hospital based cross sectional study was conducted from April 30 to July 12, 2021 at DBCSH. A systemic random sampling technique was used to select 370 patients with TIIDM. The data were collected based on structured questioners. The data were analysed using Statistical Package for the Social Sciences version 25. Association between predictive and dependent variables were checked by using both bi-variable and multivariable logistic regression model. Pvalue < 0.05 was considered as having significant association.

Results: There were high diabetic specific (30%) and patient specific (24.6%) medication regimen complexity (MRC). Higher patient specific MRC was significantly associated with poor glycaemic control (AOR=5.570; 95% CI=2.297-13.460). It also showed that high MRC score related with poor adherence (r= -0.201, P= <0.0001) and poor health related quality of life (HRQoL) (r= -0.141, P= <0.0001). Majority (52.2%) of the patients had poor glycemic control, 58.1% of the patients were categorized to have high medication adherence, and most (53.8%) of the patients had high HRQoL. Conclusion: The finding of this study showed that patients with TIIDM had high medication regimen complexity. It also revealed that high MRC score significantly associated with poor glycaemic control, HRQoL and adherence. Simplification of a complex regimen should be considered by health care providers to improve clinical outcome. Key words: Medication regimen complexity, Type II diabetic mellitus, glycaemic control, adherence, HRQoL