Geriatric Type 2 diabetes; the risk factors and associations for medication non-adherence.
Objectives: To determine medication adherence in geriatric type 2 diabetes cases, risk factors for non-adherence and association with functional dependence. Study Design: Descriptive cross sectional. Setting: Department of Medicine, RIHS Islamabad. Period: Sept. 2016 - Feb. 2017. Material & Methods: 100 type 2 diabetes cases (>65 years) included in group-A (geriatric group) and 100 gender matched type 2 diabetes cases (<65 years) in group-B (non-geriatric group). Type 1 diabetes cases, critically ill and with incomplete medication record were excluded. Morisky Diabetes Questionnaire (MMAS-8) applied for medication adherence. Glycemic control, diabetes duration, co-morbids, treatment regime, poly-pharmacy, alternative medicine, functional status (Katz index) and visual morbidity assessed in both groups. Data analyzed by SPSS V-20 and Chi-square test applied with significant p < 0.05. Results: Mean age was 71.43+5.58 years (group-A) vs. 49.28+6.57 years (group-B). Mean diabetes duration was 9.61+8 years (group-A) vs. 7.4+4.9 years (group B). Functional status was independent in 53%(group-A) vs. 86%(group-B), significantly dependent 40%(group-A) vs. 11%(group-B) and dependent 7% (group-A) vs. 3% (group-B). High adherence in 3% (group-A) vs. 10%(group B); medium 24%(group-A) vs. 32%(group-B) and low 73%(group-A) vs. 58% (group B). Non-adherence in 73%(group-A) vs. 58%(group-B). Poly-pharmacy, co-morbids, combination anti-diabetes regimes, visual morbidity, physical dependence and poor glycemic control was frequent in geriatric diabetes cases (p<0.05). Conclusions: Medication adherence has pivotal role to attain target glycemic control. Higher medication non-adherence in geriatric diabetes cases needs to be addressed. Counseling sessions supported by literature in local language and addressing the identified risk factors may improve medication adherence in geriatric diabetes cases, hence improved glycemic control and morbidity.