Evaluating Drug Regimens and Compliance Issues in Diabetes Management: A Hospital-Based Study in North India

Abstract

Background: Despite the availability of various therapeutic options, achieving optimal glycemic control remains a major challenge in clinical practice. One of the primary barriers to effective diabetes management is poor medication adherence. Non-adherence is a common issue among patients with chronic illnesses and is particularly prevalent in diabetes due to the need for long-term therapy, polypharmacy, adverse effects of medications, lack of patient education, economic constraints, and complex dosing regimens. Methodology: A cross-sectional, observational study was conducted in which Structured Case Record Form (CRF) was Used to collect data on Demographics (age, gender, socioeconomic status), Clinical details (duration of diabetes, comorbidities, complications), Current medications (drug names, dose, frequency, combination), Investigations, if available (HbAlc, fasting and postprandial glucose, renal function). The Morisky Medication Adherence Scale (MMAS-8) was used to assess adherence and Face-to-face interviews were conducted to assess factors influencing adherence such as, Awareness about diabetes, Side effects, Cost of therapy, Family and social support, Frequency of follow-up. Results: Metformin was the most prescribed drug (65%), followed by sulfonylureas (40%) and DPP-4 inhibitors (28%). Insulin was prescribed to 18% of patients, mostly in those with poor glycemic control or long-standing diabetes. Only 28.8% of patients demonstrated high adherence. A majority had moderate (39.2%) or low adherence (32.0%). Conclusion: Metformin was the most commonly prescribed drug, with a high prevalence of combination therapies. However, only 28.8% of patients demonstrated high adherence, while factors such as polypharmacy, low literacy, and high drug costs contributed to poor compliance.