Self Care and Medication Adherence among Type 2 Diabetics in Puducherry, Southern India: A Hospital Based Study

Background: Micro and macro-vascular complications of Type 2 Diabetes mellitus (DM) could be decreased by maintaining a good glycaemic control, which is dependent on adherence to medication and self care. Aim: (1) To assess medication adherence and adherence to self care among type 2 diabetics who were admitted to a tertiary care hospital (2) To identify factors which were associated with medication adherence. Materials and Methods: This descriptive study involved 150 inpatients of Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), a teaching hospital in Puducherry, southern India. Subjects who had type 2 DM for more than 1 month were included in the study, irrespective of their diagnoses at admission. They were interviewed within 24 hours of their admissions by using a predesigned, pre-tested, structured questionnaire. The questionnaire included Morisky Medication Adherence Scale (MMAS) and questions for assessing adherence to self care activities. The factors which were associated with medication adherence were identified by Chi-square test and logistic regression. Results: The mean age of the subjects was 54 years. Only 49.3% (95% CI: 41% to 57%) of the diabetics had high medication adherence (MMAS score = 8). Only 22.7% of the diabetics were involved in physical exercise for at least 30 minutes, for at least 4 days in a week. Only 16.7% of them regularly inspected their feet. Around 67.3% of the subjects reported about consuming a diabetic diet for at least 4 days/week. Poor family support showed a significant association with low medication adherence. Conclusion: Only 49.3% of the subjects adhered to anti-diabetic medications. Less than 25% of the diabetics adhered to self care activities such as exercising/walking for 30 minutes on at least 4 days in a week, regularly inspected their feet and provided feet care. Family support played a vital role in medication adherence among the diabetic subjects. Hence, it is important to regularly assess patients for medication adherence and include their families also in counseling sessions.