Factors associated with non-adherence among type 2 diabetic patients in primary care setting in eastern Bosnia and Herzegovina.

Abstract

The aims of this study were to assess patients' non-adherence and associated factors to antidiabetic medication in the primary care setting in the eastern part of Bosnia and Herzegovina (BiH). We conducted a retrospective chart review of 323 patients with type 2 diabetes mellitus (T2DM) attending the primary health care center of the Foča municipality in eastern part of BiH and measured adherence to antidiabetic medication. Adherence was measured using a pill count method. The majority of patients were treated with oral therapy (84.21%). Half of the patients (48%) treated pharmacologically were non-adherent and patients on oral and insulin combination therapy showed better adherence than those on oral therapy. Age (B=-0.749; p=0.004), copayment (B=0.549; p=0.028) and oral therapy (B=0.827; p=0.045) were the strongest predictors of poor adherence. About half of the patients were non-adherent to antidiabetic medication. Interventions oriented towards policy changes regarding availability of antidiabetic medication through copayment reductions, and providing healt education to younger population and patients on oral therapy could lead to better adherence among T2DM patients in eastern part of BiH.