Impact of Mental Ill Health on Medication Adherence Behaviour in Patients Diagnosed with Type 2 Diabetes

Abstract

The prevalence and cost of type-2-diabetes mellitus (T2DM) are escalating globally. The comorbidities between T2DM, depression and anxiety are common. Achieving high adherence to therapy, supported by lifestyle adjustment is the gold standard for good diabetes management. This study aimed to explore the impact of mental ill-health on medication adherence behaviors in patients diagnosed with T2DM. Participants were recruited from a single general medical practice in Birmingham, and randomly allocated into group A and group B. All participants had their HbA1c and blood pressure (BP) measured, their medication adherence, depression, and anxiety screened at each consultation. Of 64 patients, those with secondary school education, physically active, unemployed, did not have online access to resources, were mentally healthy and from Pakistani ethnicity, had better diabetes medications adherence. Regression analysis showed a significant statistical difference (p<0.05) in the unintentional diabetes medication adherence and anxiety scores favoring group A. BP showed a significant difference between baseline and endpoint but no difference was observed between groups. The use of Morisky (R) software has allowed the screening of the underlying cause of medication adherence, depression, and anxiety promptly. The study identified the importance of medication adherence in diabetes and the impact this has on HbA1c and mental health. The study also proposed two algorithms, one for T2DM patients in general and one for patients from the Muslim faith, and showed how clinicians can adapt their consultations to meet the needs of an individual.