Evaluation of the adherence to antidiabetic medications among Iraqi patients with T2DM using the Iraqi antidiabetic medication adherence scale (IADMAS)

Abstract

Background and Aims: Management of diabetes is a multifactorial process, and adherence to treatment programs plays a role in glycemic control. The present study evaluates the adherence rate to the antidiabetic medications with a newly developed scale and patients' HbA1c levels among Iraqi patients with type-2 diabetes. Methods: A cross-sectional study among adult patients receiving diabetic care in public and private healthcare settings with-in Baghdad City was conducted. The medication adherence was evaluated using the Iraqi Antidiabetic Medication Adherence Scale (IADMAS) to determine the factors associated with non-adherence to anti-diabetic medications. Glycated hemoglobin (HbA1c) levels of the participants were used as an indicator of glycemic status. Results: The outcome measures include the comparison between glycemic status and the claims of antidiabetic medication adherence of patients with T2DM, in addition to the expected benefits to clinical practice. A total of 442 patients with type 2 diabetes participated in the study and responded by completing the given questionnaire (response rate: 96.1%). The prevalence of non-adherence to medication was reported to be no more than 30%. Adherence based on HbA1c values reflected a high false-positive value of adherence with an extremely high true negative value. The adherence of Iraqi patients to their medications demonstrated a high negative predictive value (0.905) and a high sensitivity (0.928) with low specificity (0.156) values. Conclusion: The use of IADMAS in this study failed to confirm the consistency between the apparent claims of adherence to anti-diabetic medications and the HbA1c value as a marker of glycemic control.