OBJECTIVE: There has been a rise in geriatric diabetic population along with increased life expectancy. Current study was conducted to determine medication adherence in geriatric type 2 diabetics and study the risk factors for non-adherence and association with functional dependence. STUDY DESIGN: Descriptive cross sectional. SETTING: Dept. of Medicine, Rawal Institute of Health Sciences Islamabad. STUDY DURATION: Sept. 2016 to Feb. 2017. MATERIAL AND METHODS: 100 type 2 diabetics (>=65 years) included in group-A (geriatric group) and 100 gender matched type 2 diabetics (<65 years) in group-B (non-geriatric group). Type 1 diabetics, critically ill patients, diabetics on diet control alone and those without record of prescribed medications were excluded. Morisky Diabetes Questionnaire (MMAS-8) applied for medication adherence. Glycaemic control, diabetes duration, co-morbids, treatment regime, poly-pharmacy, alternative medicine, functional status (Katz index) and visual morbidity was assessed in both the groups. Data analyzed by SPSS V-20 and Chi-square test applied with significant p<0.05. RESULTS: Among 200 cases, mean age was 71.43+5.58 years (group-A) vs. 49.28+6.57 years (group-B). Mean duration of diabetes was 9.61+8 years (group-A) vs. 7.4+4.9 years (group B). Functional status (Katz score) was independent in 53% (group-A) vs. 86% (group-B), significantly dependent 40% (group-A) vs. 11% (group-B) and dependent 7% (group-A) vs. 3% (group-B). High medication adherence in 3% (group-A) vs. 10% (group B); medium in 24% (group-A) vs. 32% (group-B) and low in 73% (group-A) vs. 58% (group B). Non-adherence; (i.e. MMAS-8 <6) in 73% (group-A) vs. 58% (group-B). Geriatric diabetics had significantly high frequency of poly-pharmacy, co-morbids, combination anti-diabetic regimes, visual morbidity, physical dependence and poor glycemic control (p < 0.05). CONCLUSION: Medication adherence has pivotal role to attain target glycemic control. Higher medication non-adherence in geriatric diabetics needs to be addressed. Counseling sessions suggested for elderly diabetics, supported by literature in local language. Addressing the identified risk factors may improve medication adherence in geriatric diabetics, hence improved glycemic control and morbidity.

Medication non-adherence in geriatric type 2 diabetics; risk factors and association with functional dependence