DOI: 10.4103/bjem.bjem_40_26 ISSN: 2949-7973

Medication Burden and Side Effect Perception Associated with Medication Non-adherence in Type 2 Diabetes: A Comparative Study Based on Multimorbidity Status

A. S. M. Rizwan, Sharmistha Ghosh, Tasnim Ahmed
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Abstract

Background:

Medication non-adherence is a major challenge to optimal glycemic control in type 2 diabetes mellitus (T2DM), particularly when compounded by multimorbidity.

Objectives:

The aim of this study was to evaluate the relationships between objective medication burden (regimen complexity) and subjective side effect perception with self-reported medication non-adherence among patients with T2DM across a spectrum of chronic comorbidities.

Methodology:

A hospital-based, cross-sectional study was conducted among 213 patients with T2DM at a specialized tertiary care facility in Bangladesh. Purposive sampling was used to recruit participants from the outpatient department. Structured interviews recorded demographics, dosing frequencies, and six comorbidities.

Results:

The overall proportion of patients classified as non-adherent due to dose-skipping behaviors was 76.1% ( n  = 162). Subjective side effect perception escalated across the multimorbidity spectrum, rising from 31.6% in isolated T2DM to 83.3% in patients managing four concurrent comorbidities ( P  = 0.011). In the adjusted multivariate logistic regression model, standard demographic factors, the absolute number of daily medications ( P  = 0.707), and the total comorbidity score ( P  = 0.080) were not significantly associated with non-adherence. However, the subjective perception of side effects showed a strong, statistically significant association with non-adherence, with patients perceiving side effects being four times more likely to report dose-skipping behaviors (adjusted odds ratio = 4.08, 95% confidence interval: 1.98–8.40, P  < 0.001).

Conclusion:

Multimorbidity is cross-sectionally linked to higher regimen complexity and an increased reporting of drug side effects. Self-reported medication non-adherence is more strongly associated with the subjective experience of physical side effects than the objective count of chronic illnesses or prescribed pills.

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