The predictors to medication adherence among adults with diabetes in the United Arab Emirates

BACKGROUND Diabetes is a chronic medical condition and adherence to medication in adults with diabetes is important. Identifying predictors to medication adherence in adults with diabetes would help identify vulnerable patients who are likely to benefit by improving their adherence levels. METHODS We conducted a cross-sectional study at the Dubai Police Health Centre between February 2015 and November 2015. Questionnaires were used to collect socio-demographic, clinical and disease related variables and the primary measure of outcome was adherence levels as measured by the Morisky Medication Adherence Scale (MMAS-8©). Multivariate logistic regression was carried out to identify predictors to adherence. RESULTS Four hundred and forty six patients were interviewed. Mean age 61 year +/- 11. 48.4 % were male. The mean time since diagnosis of diabetes was 3.2 years (Range 1-15 years). Two hundred and eighty eight (64.6 %) patients were considered non-adherent (MMAS-8© adherence score < 6) while 118 (26.5 %) had moderate adherence (MMAS-8© adherence score 6 = <8) and 40 (9.0 %) high adherence (MMAS-8© adherence scores <8) to their medication respectively. The strongest predictor for adherence as predicted by the multi-logistic regression model was the patient's level of education. A technical diploma certificate as compared to a primary school level of education was the strongest predictor of adherence (OR = 66.1 CI: 6.93 to 630.43); p < 0.001). The patient's age was also a predictor of adherence with older patients reporting higher levels of adherence (OR = 1.113 (CI: 1.045 to 1.185; p = 0.001 for every year increase in age). The duration of diabetes was also a predictor of adherence (OR = 1.830 (CI: 1.270 to 2.636; p = 0.001 for every year increase in the duration of diabetes). Other predictors to medication adherence include Insulin use, ethnicity and certain cultural behaviours. CONCLUSION A number of important predictors to medication adherence in diabetics were identified in this study. Such predictors could help develop policies for improving adherence in diabetics.