Factors Influencing Medication Adherence Among Patients with Diabetes Mellitus and Hypertension in Nigeria (Published)
Medication non-adherence results in increased morbidity, mortality and financial loss. Reasons for medication non-adherence are multifactorial. This cross-sectional study was conducted to determine the prevalence of, and factors contributing to medication non-adherence among patients with diabetes mellitus and hypertension attending some secondary and tertiary health care facilities in Lagos, Nigeria. Of the 100 patients, 32% were compliant with their medications. Most (39%) respondents were noncompliant because of lack of funds and cost of medication, 19% due to forgetfulness, 16% because they felt well, and 15% due to non-availability of drugs at the pharmacy. Other reasons for non-compliance include illnesses (9%), side effects of medications (1%) and misinterpretation of prescription (1%). Among the socio-demographic variables studied, only male gender was positively associated with medication compliance. Adherence to anti-diabetics and anti-hypertensives was low. Both health system and patients’ related issues contributed to poor compliance and these should be addressed to improve medication adherence.
Keywords: Adherence, Diabetes Mellitus, Hypertension, Nigeria
Illness-Perception Among Diabetes Mellitus Patients in Selected Hospitals, Benin-City, Edo State, Nigeria (Published)
The study determined illness-perception among diabetes mellitus patients in selected hospitals, Benin-city, Edo State, Nigeria. The study specifically assessed the level of illness-perception among people living with diabetes mellitus in Benin-City. This study adopted descriptive cross-sectional method. The sample for the study was obtained from the total population of Nine hundred and sixty-eight (968), using Slovin’s Formula. The instrument used for data collection was a self-designed questionnaire which consisted of two sections. Internal consistency method was used to ascertain the reliability of the instrument. The reliability of the instrument was calculated using Cronbach’s Alpha which yielded coefficient value 0f 0.813. Data collected from respondents through questionnaire were analysed using descriptive statistics. Results showed that the respondents demonstrated high level of illness- perception with mean scores of; perceived susceptibility 4.05± .939, perceived severity 3.76± 1.112, perceived threat 3.89± 1.107 and perceived benefit 3.60± 1.077. Result also showed that 66.7% of participants had high level of ill-perception. The study concluded that respondents have high illness-perception which is likely to inform them about specific diabetes self-care management actions. It was recommended that there was need for nurses to continuously educate patients on characteristics of the diabetic disease that seems severe, symptoms of DM that interfere with their activity, complications that may occur due to diabetes and complex treatment rules.
Keywords: Diabetes Mellitus, illness-perception, selected hospitals
Serum Lipids and Glycated Haemoglobin Levels in Pre- and Post- Menopausal Diabetic Subjects in Enugu, Nigeria (Published)
Background: Studies have shown that poorly controlled diabetes mellitus result to significantly deranged lipid profile and atherogenic indexes in diabetic patients, thus they are at increased risk of dyslipidaemias. With respect to age and stages of a diabetic woman’s life, there is much increased risk. Aim: The study was aimed to evaluate the lipid and glycated haemoglobin levels of pre- and post-menopausal women suffering from type 2 diabetes mellitus. Materials and Methods: A total of 148 known type 2 diabetic women (60 pre-menopausal and 88 post- menopausal women) and 90 healthy non-diabetic women (40 pre-menopausal and 50 post-menopausal women) were included in the study. HBA1c, total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) and very low density lipoprotein-cholesterol (VLDL-C) were determined using standard methods.Findings: This study showed that the HDL-C level was significantly lower (p<0.05) in both groups of diabetic women compared to their respective controls. In pre-menopausal diabetic women, with the exception of LDL-C, other lipid parameters and ratios (TC/HDL-C and TG/HDL-C) show significantly increased mean results (p<0.05) compared with that of the control. Increased TG, VLDL-C, and atherogenic indexes (TC/HDL-C and TG/HDL-C ratios), and reduced HDL-C levels (p<0.05) were the significant lipid alterations found in post-menopausal diabetic women compared to their age-matched controls. Furthermore, the study revealed that TC and HDL-C increased significantly (p<0.05) in post–menopausal diabetic women when compared with pre–menopausal diabetic women. Conversely, VLDL-C and TG levels together with the lipid ratios were found to decrease significantly (p<0.05) in post-menopausal diabetic women when compared with pre-menopausal diabetic women. The study also revealed that in pre-menopausal diabetic subjects HbA1c at p<0.01 correlated with some of the lipid parameters and the atherogenic indexes. Nonetheless, in the post-menopausal diabetic subjects no significant relationships (p>0.05) between HbA1c and all the lipid parameters and ratios were observed.
Conclusion: This finding suggests that early detection and modification of poor glycaemic control and the accompanying specific lipid abnormalities may improve the health of the diabetic subjects.
Keywords: Diabetes Mellitus, Lipid profile, glycated haemoglobin, postmenopausal, premenopausal