Association of medication adherence and glycemic control with pain severity among patients with diabetes mellitus: a cross-sectional study from Palestine

Abstract

Background: The evaluation of pain and medication compliance in patients with type 2 diabetes mellitus is essential for efficient illness management. This study aimed to assess the associations of medication adherence and glycemic control with pain severity among patients with diabetes mellitus. Methods: This study was conducted with a cross-sectional design. The study used the Arabic versions of the Brief Pain Inventory Scale and the Medication Adherence Rating Scale. The patients were included from different healthcare centers in Nablus city. The data were collected via a structured questionnaire. Results: In this study, 377 patients were included. Of those, 244 (64.7%) were female. The median age of the patients was 62 [IQR: 55.5, 68.0] years. The median time since the diagnosis of type 2 diabetes mellitus was 8 [IQR: 4.0, 15.0] years, and the HbA1c level was 7.8% [IQR: 6.8%, 9.0%]. Among the patients, 162 (43.0%) had no pain, 92 (24.4%) had mild pain, 43 (11.4%) had moderate pain, and 80 (21.2%) had severe pain. The median adherence score was 8.0 [7.0, 9.0]. In the multivariable analysis, pain severity was significantly associated with factors such as not having a formal education (B = − 0.21, p = 0.007), ankle pain (B = -1.01, p < 0.001), orphenadrine use (B = − 2.08, p = 0.005) and higher pain interference scores (B = 0.45, p < 0.001). For medication adherence, significant predictors included older age (B = 0.01, p = 0.038), the use of glimepiride (B = − 0.34, p = 0.009), and the use of duloxetine (B = 1.21, p = 0.022). No significant association was found between medication adherence and pain severity (p = 0.617). Conclusions: Pain severity was most strongly associated with pain interference, educational level, ankle pain, and the use of orphenadrine. Medication adherence was significantly predicted by older age, the use of glimepiride, and the use of duloxetine. These findings highlight key factors influencing pain and adherence among patients with diabetes mellitus.