Assessment of Medication Adherence Among Diabetic Mellitus Patients in a Tertiary Care Hospital

Diabetic Mellitus is a commonly known disease referred to as diabetics, needs to followmedication consistentlywithout a break to keep the blood sugar level in control. Consistentmedicationdealswith ameasure of howpatients adhere to their medications and is done by health care providers. This is very important because it ensures that the patient follows the doctors order correctly and also ensure that the treatment is not just based on a therapeutic contract betweendoctor andpatient. Thismonitoring is veryhigh,withpatients having serious problems with diabetics and is reported low for chronic patients. The aim of this study is to assessmedication adherence in type 2 diabetes patients. The study was carried out at Saveetha Medical College. Data was collected using a standardized questionnaire. Data entered in MS Excel and analyzed using Weka 3.8.3 and results interpreted. The best way health professionals can tackle the adherence problem is through quality patient counselling, as done in this study.

Medication Adherence, Patient Counseling, Diabetics, OHA A Diabetic Mellitus is a commonly known disease referred to as diabetics, needs to follow medication consistently without a break to keep the blood sugar level in control. Consistent medication deals with a measure of how patients adhere to their medications and is done by health care providers. This is very important because it ensures that the patient follows the doctors order correctly and also ensure that the treatment is not just based on a therapeutic contract between doctor and patient. This monitoring is very high, with patients having serious problems with diabetics and is reported low for chronic patients. The aim of this study is to assess medication adherence in type 2 diabetes patients. The study was carried out at Saveetha Medical College. Data was collected using a standardized questionnaire. Data entered in MS Excel and analyzed using Weka 3.8.3 and results interpreted. The best way health professionals can tackle the adherence problem is through quality patient counselling, as done in this study.

INTRODUCTION
Diabetic Mellitus is a commonly known disease referred to as diabetics, needs to follow medication consistently without a break to keep the blood sugar level in control. Consistent medication deals with a measure of how patients adhere to their medications and is done by health care providers. This is very important because it ensures that the patient follows the doctors order correctly and also ensure that the treatment is not just based on therapeutic Commitment among doctor and patient (Steiner and Earnest, 2000). This monitoring is very high, with patients having serious problems of diabetics and is reported low for chronic patients (Jackevicius, 2002;Cramer et al., 2003). The ability of doctors to know about the medication adherence of patients is very dif icult and complex. (Burnier, 2000;Haynes et al., 2002), lack of such information lead to loss of lives and extensive fall of health (McDonnell and Jacobs, 2002;Schiff et al., 2003). Diabetics once affected can never be recovered but can be kept under control only at the cost of proper and regular medication. Type -2 Diabetics is a very serious problem for the age group above 40 and is almost covers 80% of the current population in that age group (Misdrahi et al., 2002;Rodgers and Ruf in, 1998). It is very hard to diagnose, as the symptoms are less prominent and unnoticeable. There are cases resulting in fetal death as a result of being unnoticed over many years. Some of the symptoms include frequent urination, unusual thirst, fatigue and tiredness.
Many methods can be adopted to improve the monitoring of medication adherence of patients. Some of them can be conducting frequent reviews, increasing the working time of the clinic, educating the patients and improving the dose schedules (Murphy, 2003;Stuart and Zacker, 1999). Current technolo-gies can also be used to send reminders to patients regarding their dosage changes and schedules. This can also be used to remind the patients regarding their doctors' appointments. Also, effective communication between doctor and patient can also improve the patients to follow and adhere to prescribed medications (Patton et al., 1997;Mathew and Rajiah, 2014). This study concentrates on assessing the amount of adherence to the medication of diabetic patients in a health care center which is considered to be most important for the wellbeing of patients.

Study design
A cross sectional observational study

Study period
October 2019 to March 2020.

Study participants
Inclusion criteria were patients diagnosed with type 2 diabetes mellitus, aged 30 years and above, patients taking one or more OHAs for the last six months, willing to provide informed consent.
Exclusion criteria were patients on OHAs for less than six months, diabetic patients on injectable hypoglycaemic agents alone or in combination with OHAs, diabetic patients with diagnosed psychiatric problems.

256
Data was collected using a standardized questionnaire. Data entered in MS Excel and analyzed using Weka 3.8.3 and results interpreted.

RESULTS AND DISCUSSION
256 patients were involved in the study. From the results gotten, there were 134 (52.7%) male and 122 (48.03 %) female patients and the majority of them were in the age group of 51 to 65 years (Table 1). (Table 2) speci ies the disease related parameters in the study participants of the current study.
Out of 256 study participant the duration of onset of Diabetes, 210(82%) participant are between 0-5 years, 33(12.9) are between 6-10 years, 3(1.1%) are between 11-15 years, 5(2%) are between 16-20 years and 5(2%) are >20 years. Among the study participants, 82.03 % were on oral anti-hypoglycaemic agents and 17.96% of subjects were on both OHA and Insulin. The mean duration of Diabetes mellitus was 9.592 ± 7.521 years in the study population. Table 3 shows the treatment adherence for diabetes mellitus of the study population at baseline. As per medication intake, 231(90.2%) were taking proper medication. Among the study participants, 18.75% had high compliance, 57.03% had a medium level of compliance and 24.21% had low compliance with treatment at the baseline (Figure 1).
The indings of this observe revealed that medicine adherence changed into low. Worldwide research using various studies, assessment gadgets and systematic evaluations has addressed poor medicinal drug adherence amongst diabetic patients. It changed into discovered that many patients forgot to take drug treatments with them while they're away from domestic. Others felt that it was very tough to stick to treatment plans and so stopped the medications. The indings are compared to several studies documented as terrible remedy adherence in diabetic sufferers. A study performed with Shaimol et al. suggested that 21.8% of the patients showed excessive adherence, 43.3% slight adherence, and 35.3% low adherence to the remedy. Priyanka et al. documented that most of the people had high remedy adherence. The majority of diabetics had ine ideas about the need for their medication and this can have resulted in high adherence. Arulmozhi and Mahalakshmi reported that 49.8% had been excessive, 24.7% have been mild,   can play a irst-rate position in enhancing remedy adherence with the aid of growing interplay with sufferers. The health practitioner-patient dating plays a primary function in retaining the affected person nicely knowledgeable approximately the medicines they consume. Patient adherence, while the remedy is simple, appears powerful. If they accept as true with the bene its exceed expenses and their surroundings helps regimen-related behaviors, their medicine adherence improves.

CONCLUSIONS
Improving medicinal drug adherence complements patient protection. It is critical for the health care experts to assess the affected person and foresee the feasible causes of non-adherence to attain the best itness inal results. In addition to numerous other elements affecting medicine adherence, clinical pharmacist and different health care experts should be aware of providing understanding about Diabetes that the patients deliver towards medication adherence.