Adherence to therapy among Iraqi patients with type 2 Diabetes Mellitus

Abstract

Background :-adherence to therapy is defined as the extent to which a person’s behavior in taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a healthcare provider. Patients presenting with type 2 diabetes mellitus are initially encouraged to maintain a healthy diet and exercise regimen, followed by early medication that generally includes one or more oral hypoglycemic agents and later may include an injectable treatment. To prevent the complications associated with type 2 diabetes, therapy frequently also includes medications for control of blood pressure, dyslipidemia and other disorders, since patients often have more than three or four chronic conditions.

Aim :-Despite the benefits of therapy, studies have

indicated that recommended glycemic goals are achieved by less than 50% of patients, which may be associated with decreased adherence to

therapies. Measure the adherence to therapy among Iraqi patients with type 2 diabetes mellitus.

Materials and amethods:-Various measures to increase patient satisfaction and increase adherence in type 2 diabetes have been investigated. These

include reducing the complexity of therapy by fixed-dose combination pills and less frequent dosing regimens, using medications that are associated with fewer adverse events (hypoglycemia or weight gain), educational initiatives with improved patient–healthcare provider communication, reminder systems and social support to help reduce costs.

Results :-As a result, hyperglycemia and long term complications increase morbidity and premature mortality, and lead to increased costs to health services. Reasons for no adherence are multifactorial and difficult to identify. They include age, information, perception and duration of disease, complexity of dosing regimen, poly therapy, psychological factors, safety, tolerability and cost.

Conclusions:-It is evident from many studies that type 2 diabetes is a progressive disease pharmacologic treatment is essential to maintain glycemic control and reduce adverse cardiovascular outcomes. Even though adherence to medications leads to beneficial outcomes, it was found to be suboptimal. High cost of medications was significantly associated with poor antidiabetic drug adherence, other reasons for poor adherence including age, social and psychological factors, education and a lack of understanding of the long-term benefits of treatment, the complexity of the medication regimen, cost of medication and negative treatment perceptions. Poor communication between doctor and patient, adverse outcomes such as weight gain and hypoglycemia, and failure of clinicians to modify medications appropriately can also affect adherence.

Keywords:- diabetic , adherence , medications , adverse effect , cost