Invastigation of treatment adherence and the factors affecting it in type 2 diabetes patients in Kutahya

Diabetes is a chronic disease that is frequent in incidence both in our country and around the world. The management of both diabetes and its complications accounts for a significant part of health expenditures. Most of the complications can be prevented by good adaptation to the treatment. This is a cross-sectional research that was conducted to investigate the factors affecting the treatment adherence of patients diagnosed with type 2 diabetes in the city of Kütahya, Türkiye. The study group consists of 227 patients with a type 2 diabetes diagnosis who were admitted to the internal medicine outpatient clinic of Kütahya Evliya Çelebi Training and Research Hospital between the months of January 2023 to October 2023. A questionnaire with patients' demographic information and a scale of adaptation to the type 2 diabetes treatment was inquired of the patients. In addition, data on HbA1c and fasting glucose levels under outpatient clinical control were collected. Statistical analyses of the data obtained from those were performed using a package program called SPSS (IBM SPSS Statistics 27). Frequency tables and descriptive statistics were used for the interpretation of the findings. It was determined that the average age of the subjects was 60.20±9.61 (years) and that 84 people (37.0%) were in the ≥65 age group. 135 of the 227 patients (59.5%) were women, 214 (94.3%) were married and 205 (90.3%) were living as a nuclear family. 105 of the applicants (46.3%) were primary school graduates, 110 (48.5%) were unemployed, and 190 (83.7%) had income equal to their expenses. 82 (36.1%) were overweight, 96 (42.3%) walked/exercised 3 or more times a week, 180 (79.3%) did not smoke, and 220 (96.9%) did not drink alcohol. 137 patients out of total (60.4%) received oral anti-diabetic therapy before the study, 119 (52.4%) received diabetes education once in their lives, and 131 (57.7%) received dietitian support. In addition, only 95 of the study group (41.8%) had no acquaintances or friends with diabetes. The average insulin application frequency per day was found to be 2.74±1.32, while the average number of additional diseases was 1.93±1.07 and the average number of total pharmacotherapeutic drug used by the applicants was 4.30±1.93. The average HbA1c value of the patients was detected as 8.29±1.93 and the average fasting blood sugar was 175.56±78.82. The general average of the Type 2 Diabetes Medication Adherence Scale (T2-DMAS) scores was found to be 84.25±17.09. The median score was 85, while the lowest score was 37, and the highest score was 131. Consequently, adherence to medical treatment was identified as moderate. It was determined that the overall T2-DMAS scores of patients who use both insulin and oral anti-diabetics were significantly higher than those who only use oral anti-diabetics. In addition, adherence was significantly better in patients who have more advanced educational level and normal body mass index levels. Patients who have received an education for diabetes were also more compliant to the treatment. Contrarily, it was demonstrated that as the levels of HbA1c and blood sugar increased, medication adherence reduced. To conclude our study, we suggest that compliance would rise when the treatment is simpler to understand and easier to use.