The Journal of Health, Population and Nutrition
Vol. 38, No. 1, 2019, pp. 1-8
Bioline Code: hn19006
Full paper language: English
Document type: Research Article
Document available free of charge
The Journal of Health, Population and Nutrition, Vol. 38, No. 1, 2019, pp. 1-8
© Copyright 2019 - The Author(s)
Comparison of medication adherence between type 2 diabetes mellitus patients who pay for their medications and those who receive it free: a rural Asian experience|
Rathish, Devarajan; Hemachandra, Ruvini; Premadasa, Thilini; Ramanayake, Sasini; Rasangika, Chathuri; Roshiban, Ravi & Jayasumana, Channa
Background: Treatment plans fail if patients have poor medication adherence. Our aim was to compare
medication adherence, reasons for non-adherence, and satisfaction with community support among type 2
diabetes mellitus patients who pay for their medications and those who receive it free.
Methods: A descriptive cross-sectional study was conducted at Anuradhapura, Sri Lanka, among patients who were
on oral anti-diabetic drugs for at least 3 months. They were grouped into two: universal-free group and fee-paying
group. Three different scales were used to score medication adherence, reasons for non-adherence, and satisfaction
with community support. Fisher’s exact test was performed to determine if there was a significant difference
between the two groups (p < 0.05) concerning medication adherence and satisfaction with community support.
Results: The median (IQR) medication adherence scores for fee-paying group and universal-free group were 3 (2-3)
and 3 (3-3), respectively; the median (IQR) scores for satisfaction with community support were 5 (2–6) and 4 (4–6),
respectively. Both the adherence and the satisfaction failed to show a significant difference between the two groups.
Forgetfulness, being away from home, complex drug regime, and willingness to avoid side effects were common
reasons of non-adherence for both the groups.
Conclusions: There was no significant difference in medication adherence between the universal-free group and feepaying
group, despite of having a significantly different income. The universal-free health service would be a probable
Non-adherence; Community support; Diabetes mellitus; Rural sector; Sri Lanka; Universal-free
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