Evaluation of Medication Regimen Complexity and its effect on medication adherence and glycemic control among patients with Type 2 Diabetes Mellitus attending Debre Tabor General Hospital, Northwest, and Ethiopia

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.