Concurrent And Longitudinal Association Between Glycemic Control And Self Reported Medication Adherence Among Type 2 Diabetes Patients At A Tertiary Care Hospital In Malaysia

Author(s): Mubashra Butt , Adliah Mhd Ali* , Mohd Makmor Bakry .

Journal Name: Current Diabetes Reviews

Volume 15 , Issue 5 , 2019

Become EABM
Become Reviewer


Background: This study evaluated the association between self-reported adherence with concurrent and subsequent glycemic control amongst type 2 diabetes patients at a tertiary care hospital in Malaysia.

Methods: Demographic and clinical variables were assessed at baseline, after three and six months in 73 type 2 diabetes patients. Regression analysis, using SPSS, evaluated the concurrent and longitudinal association of medication adherence and glycemic control. Potential confounders of variables were identified using bi-variate correlation analyses.

Results: Concurrent Medication adherence and HbA1c association were significant after adjusting for ethnicity (P = 0.005). For longitudinal observation at 3 months, the association was significant after adjusting for ethnicity (P = 0.016); however, it became non-significant when baseline glycemic control was included in the model (P = 0.28).

Conclusion: Easy to administer MALMAS significantly predicted concurrent glycemic control independent of potential confounders. This association persisted in longitudinal observation after 3 months when adjusted for confounders and became non-significant after adjusting for baseline glycemic control.

Keywords: Self-reported medication adherence, type 2 diabetes mellitus, glycemic control, MALMAS, clinical variables, HbA1c.

Kiadaliri AA, Najafi B, Mirmalek-Sani M. Quality of life in people with diabetes: a systematic review of studies in Iran. J Diabetes Metab Disord 2013; 12: 1.
Wändell PE. Quality of life of patients with diabetes mellitus An overview of research in primary health care in the Nordic countries. Scand J Prim Health 2005; 23: 68-74.
Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care 2004; 27: 1218-24.
Hawkshead J, Krousel-Wood MA. Techniques for measuring medication adherence in hypertensive patients in outpatient settings. Dis Manag Health Out 2007; 15: 109-18.
Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman Med J 2011; 26: 155-9.
Paterson DL, Potoski B, Capitano B. Measurement of adherence to antiretroviral medications. JAIDS-J Acq Imm Def 1999; 2002(31): S103-6.
LaFleur J, Oderda GM. Methods to measure patient compliance with medication regimens. J Pain Palliat Care Pharmacother 2004; 18: 81-7.
DiBonaventura M, Wintfeld N, Huang J, et al. The association between nonadherence and glycated hemoglobin among type 2 diabetes patients using basal insulin analogs. Patient Prefer Adherence 2014; 8: 873-82.
Guillausseau P. Influence of oral antidiabetic drugs compliance on metabolic control in type 2 diabetes. A survey in general practice. Diabetes Metab 2003; 29: 79-81.
Heisler M, Faul JD, Hayward RA, et al. Mechanisms for racial and ethnic disparities in glycemic control in middle-aged and older Americans in the health and retirement study. Arch Intern Med 2007; 167: 1853-60.
Krapek K, King K, Warren SS, et al. Medication adherence and associated hemoglobin A1c in type 2 diabetes. Ann Pharmacother 2004; 38: 1357-62.
Aikens J, Piette J. Longitudinal association between medication adherence and glycaemic control in Type 2 diabetes. Diabet Med 2013; 30: 338-44.
Chung WW, Chua SS, Lai PSM, et al. The Malaysian Medication Adherence Scale (MALMAS): Concurrent validity using a clinical measure among people with type 2 diabetes in Malaysia. PLoS One 2015; 10e0124275 [ journal.pone.0124275].
Butt M, Ali AM, Bakry MM, et al. Impact of a pharmacist led diabetes mellitus intervention on HbA1c, medication adherence and quality of life: A randomised controlled study. Saudi Pharm J 2016; 24: 40-8.
Chua SS, Lai PS, Tan CH, et al. The development and validation of the Malaysian medication adherence scale (MALMAS) among patients with 2 type diabetes in Malaysia. Int J Pharm Pharm Sci 2013; 5: 790-4.
Ahmad NS, Ramli A, Islahudin F, et al. Medication adherence in patients with type 2 diabetes mellitus treated at primary health clinics in Malaysia. Patient Prefer Adherence 2013; 7: 525-30.
Misra R, Lager J. Ethnic and gender differences in psychosocial factors, glycemic control, and quality of life among adult type 2 diabetic patients. J Diabetes Complications 2009; 23: 54-64.
Parchman ML, Pugh JA, Wang C-P, et al. Glucose control, self-care behaviors, and the presence of the chronic care model in primary care clinics. Diabetes Care 2007; 30: 2849-54.
Trivedi AN, Zaslavsky AM, Schneider EC, Ayanian JZ. Trends in the quality of care and racial disparities in Medicare managed care. N Engl J Med 2005; 353(7): 692-700.
Piette JD, Heisler M. Problems due to medication costs among VA and non-VA patients with chronic illnesses. Am J Manag Care 2004; 10: 861-8.
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005; 353: 487-97.
Gellad WF, Haas JS, Safran DG. Race/ethnicity and nonadherence to prescription medications among seniors: results of a national study. J Gen Intern Med 2007; 22: 1572-8.
Rhee MK, Slocum W, Ziemer DC, et al. Patient adherence improves glycemic control. Diabetes Educ 2005; 31: 240-50.
Garber MC, Nau DP, Erickson SR, et al. The concordance of self-report with other measures of medication adherence: a summary of the literature. Med Care 2004; 42: 649-52.
Polonsky WH, Henry RR. Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors. Patient Prefer Adherence 2016; 10: 1299-307.
Sapkota S, Brien JA, Greenfield J, Aslani P. A systematic review of interventions addressing adherence to anti-diabetic medications in patients with type 2 diabetes-impact on adherence. PLoS One 2015; 10e0118296
Powell WP, Corathers DS, Raymond J, Streisand R. New approaches to providing individualized diabetes care in the 21st century. Curr Diabetes Rev 2015; 11: 222-30.

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2019
Page: [402 - 406]
Pages: 5
DOI: 10.2174/1573399814666180828152754
Price: $58

Article Metrics

PDF: 25
PRC: 1