Abstract:
Background: Different studies reported that higher diabetes-specific Medication Regimen
Complexity Index (MRCI) have a negative impact on glycemic control potentially by decreasing
medication adherence. However, information about regimen complexity and its association with
adherence and glycemic control in Ethiopian diabetes patients is scarce.
Aim: To evaluate medication regimen complexity and its impact on mediation adherence and
glycemic control among Type 2 Diabetes Mellitus (T2DM) Patients.
Methods: A hospital-based cross-sectional design was conducted at Debre Tabor General Hospital
from 1 may 2018-30 June 2018. Medication regimen complexity was evaluated using the 65-item
validated Microsoft Access Version 1.0 medication regimen complexity electronic data capture
tool. Adherence was measured using the 8 item MMAS-8 while patients were classified as having
poor or good glycemic control based on the recent record of their Fasting Blood Glucose.
Multivariable logistic regression analysis was applied to determine the association between
predictive variables and outcome variables.
Result: A total of 275 T2DM patients who meet the inclusion criteria were included in the final
analysis. About 22.2% of the participants were classified as having high Diabetes Specific MRCI
while 35.6% of the participants were classified as having high patient level MRCI. Majority
(70.5%) of the respondents were adherent to their medications and 42.9% of the total population
were categorized as having good glycemic control. According to the result of the multivariate
analysis, patients with low and moderate level MRCI of both diabetes specific and patient level
MRCI were more adherent to their medication compared to patients with high MRCI. High
diabetes medication regimen complexity was associated with poor glycemic control in the adjusted
analyses [(AOR = 0.276; 95% CI = 0.100, 0.759)].
Conclusion: Patients with low and moderate regimen complexity had improved adherence. High
diabetes medication regimen complexity was associated with poor glycemic control.
Simplification of a complex medication regimen for diabetic patients should be sought by
physicians and pharmacists to improve medication adherence and subsequent glycemic control.
