Non-adherence to oral antidiabetic medications among patients with type 2 diabetes: evidence from a nationwide multicenter study in a lower-middle-income country

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BioMed Central
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Non-adherence to oral antidiabetic medications among patients with type 2 diabetes: evidence from a nationwide multicentre study in a lower-middle-income country - BMC Public Health

Background Non-adherence to oral antidiabetic medications is a critical, multifactorial challenge that undermines disease management nationwide. This study aimed to determine the prevalence and predictors of non-adherence among patients with type 2 diabetes (T2DM) across Pakistan. We conducted a nationwide cross-sectional study between December 2023 and March 2025 in 225 healthcare facilities across all provinces of Pakistan. A total of 41,095 participants were selected using a multistage random sampling approach. Medication adherence was evaluated with self-reported pill counts and the Self-Efficacy for Appropriate Medication Use Scale (SEAMS). Multivariable logistic regression using a generalized linear model (GLM) logit approach was employed integrated with Interaction analysis to discover predictors of non-adherence. Result Non-adherence was present in 59.9% (n=24,616) of cases (n=24,616). Factors associated with reduced adherence included being female (AOR = 0.229, 95% CI: 0.067–0.779, P = 0.02), having only primary or secondary education (AOR = 0.186, 95% CI: 0.166–0.208, P < 0.001), absence of hospitalization, taking fewer medications per day, less frequent dosing schedules, and uncontrolled HbA1c levels. In contrast, factors linked to increased adherence were being married (AOR = 4.118, 95% CI: 3.611–4.695, P < 0.001), being a non-smoker (AOR = 12.98, 95% CI: 11.53–14.62, P < 0.001), having no family history of diabetes (AOR = 1.074, 95% CI: 1.021–1.129, P = 0.005), and having more than one comorbid condition. Conclusion Non-adherence to oral antidiabetic medication is prevalent and influenced by diverse personal, socioeconomic, and health-related factors. Targeted interventions addressing modifiable risk factors could improve adherence, ultimately reduce the healthcare burden and enhancing outcomes for patients with diabetes in Pakistan.

We're excited to share our team's recent efforts, which concluded a nationwide study in Pakistan assessing medication adherence among over 41,000 Type 2 Diabetes patients. The results, now published in BMC Public Health, are a wake-up call:

nearly 60% of patients are not adhering to their oral antidiabetic medications.

This isn't just a medical issue; it's a socioeconomic one. Our data shows that financial constraints, education levels, and even language barriers play a critical role.

What’s the solution? We cannot rely on "education-only" strategies. Our study suggests we need:

✅ Simplified dosing regimens.

✅ Targeted mHealth interventions (SMS reminders).

✅ Stronger peer-support networks in primary care.

We hope these findings will help shape smarter public health policies for chronic disease management in Pakistan. Because it’s not enough to prescribe medication, we must ensure patients can take it.

Full Paper: https://rdcu.be/eQYXf

#HealthPolicy #GlobalHealth #DiabetesAwareness #HealthcareInnovation #ResearchImpact

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