• PUTU DEWINTA DARMADA Department of, Wangaya Hospital, Denpasar, Indonesia.
  • DEWI CATUR WULANDARI Department of Internal Medicine, Wangaya Hospital, Denpasar, Indonesia.


Objective: The prevalence of diabetes mellitus continues to increase worldwide, followed by the incidence of complications, which ends up causing morbidity and mortality in patients. There were many factors related to the incidence of complications in diabetes mellitus. Patient’s adherence to their medication is considered to have an impact on the complications in diabetic patients.

Methods: The study was conducted on 68 patients with a cross-sectional method with consecutive sampling. Statistical analysis was done using the Chi-square and Fisher’s exact test. p<0.05 was considered statistically significant. Patients were interviewed using a demographic data questionnaire and medication adherence rating scale – 5 (MARS-5). Other data and diagnosis of complications were collected through medical records. The epidemiological analysis was carried out using the prevalence ratio.

Results: There were 47 (69.1%) patients with type 2 diabetes mellitus (T2DM) hospitalized due to complications, and 56 (82.4%) patients have poor adherence to treatment. There was a significant relationship between treatment adherence and the incidence of complications in diabetes mellitus patients with p = 0.001 and it was found that there was a risk of 3.14 times in patients who have poor adherence to be hospitalized due to complications.

Conclusion: Treatment adherence affects the incidence of complications in patients with T2DM.

Keywords: diabetes mellitus, medication adherence, complication, Medication adherence rating scale-5


1. World Health Organization. Global Burden of Diabetes. Global Report on Diabetes. Geneva: World Health Organization; 2016. p. 25-6.
2. International Diabetes Federation. IDF Diabetes Atlas. Brussels: International Diabetes Federation; 2019. p. 4-6.
3. Kementrian Kesehatan Republik Indonesia. Hari Diabetes Sedunia Tahun 2018, Infodatin. Jakarta: Pusat Data Dan Informasi Kementrian Kesehatan RI; 2018. p.1-7.
4. Dinas Kesehatan Provinsi Bali. Profil Kesehatan Provinsi Bali. Denpasar: Dinas Kesehatan Provinsi Bali; 2017. p. 22-3.
5. Dinas Kesehatan Kota Denpasar. Profil Dinas Kesehatan Kota Denpasar 2018. Denpasar: Dinas Kesehatan Kota Denpasar; 2019. p. 107-8.
6. Rumah Sakit Umum Daerah Wangaya. Laporan Tahunan RSUD Wangaya Kota Denpasar Tahun 2018. Denpasar: RSUD Wangaya; 2018. p. 44-5.
7. Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of Type 2 diabetes mellitus and its complications. Nat Rev Endocrinol 2018;14:88-98.
8. Perkumpulan Endokrinologi Indonesia (PERKENI). Konsensus Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia. Jakarta: PB Perkeni; 2015.
9. Baynest HW. Classification, pathophysiology, diagnosis and management of diabetes mellitus. J Diabetes Metab 2015;6:541.
10. Alqarni AM, Alrahbeni T, Al-Qarni A, Al-Qarni HM. Adherence to diabetes medication among diabetic patients in the Bisha governorate of Saudi Arabia-a cross sectional survey. Patient Prefer Adherence 2018;13:63-71.
11. Abejew AA, Belay AZ, Kerie MW. Diabetic complications among adult diabetic patients of a tertiary hospital in Northeast Ethiopia. Adv Public Health 2015;2015:290920.
12. Arambewela MH, Somasundaram NP, Jayasekara HB, Kumbukage MP, Jayasena PM, Chandrasekara CM, Fernando KR, et al. Prevalence of chronic complications, their risk factors, and the cardiovascular risk factors among patients with Type 2 diabetes attending the diabetic clinic at a tertiary care hospital in Sri Lanka. J Diabetes Res 2018;2018:4504287.
13. World Health Organization. Adherence to Long Term Therapies: Evidence for Action. Geneva: World Health Organization; 2003.
14. Kleinsinger F. The unmet challenge of medication non-adherence. Perm J 2018;22:18-33.
15. Hutchins DS, Zeber JE, Roberts CS, Williams AF, Manias E, Peterson AM, et al. Initial medication adherence-review and recommendations for good practices in outcomes research: An ISPOR medication adherence and persistence special interest group report. Value Health 2015;18:690-9.
16. American Diabetes Association. Introduction: Standards of medical care in diabetes-2020. Diabetes Care 2020;43 Suppl 1:S1-2.
17. Alfian R, Putra AM. Uji validitas dan reliabilitas kuesioner medication adherence report scale (MARS) terhadap pasien diabetes melitus. J Ilmiah Ibnu Sina 2017;2:176-83.
18. Horne J, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res 1999;47:555-67.
19. Rabba AK, Aljirisp WS, Ahmed NJ, Alkhrafy KM. Medication adherence in Type 2 diabetic patients: A study in Saudi Arabia. Int J Pharm Pharm Sci 2017;9:247-50.
20. Lee CS, Tan JH, Sankari U, Koh YL, Tan NC. Assessing oral medication adherence among patients with Type 2 diabetes melitustreated with polytherapy in developed Asian community: A cross sectional study. BMJ Open 2017;7:e016317.
21. Katadi S, Andayani TM, Endarti D. The correlation of treatment adherence with clinical outcome and quality of life in patients with Type 2 diabetes melitus. J Manag Pharm Pract 2019;9:19-26.
22. Simpson SH, Lin M, Eurich DT. Medication adherence affects risk of new diabetes complications: A cohort study. Ann Pharmacother 2016;50:741-6.
23. Horii T, Momo K, Yasu T, Kabeya Y, Atsuda K. Determination of factors affecting medication adherence in Type 2 diabetes mellitus patients using a nationwide claim-based database in Japan. PLoS One 2019;14:e0223431.
24. Alshehri KA, Altuwaylie TM, Alqhtani A, Albawab AA, Almalki AH. Type 2 diabetic patients adherence towards their medications. Cureus 2020;12:e6932.
25. Adepu SP, Sam S, Omanakuttan C, Ramanatha KV, Yashaswini Y. Assessment of pharmacist mediated education on medication adherence behavior in Type 2 diabetes mellitus patients in South Indian Rural population. Int J Pharm Pharm Sci 2018;10:39-42.
26. Rezaei M, Valiee S, Tahan M, Ebtekar F, Gheshlagh RG. Barriers of medication adherence in patients with Type-2 diabetes: A pilot qualitative study. Diabetes Metab Syndr Obes 2019;12:589-99.
27. Mandpe AS, Pandit VA, Dawane JS, Patel HA. Correlation of disease knowledge with adherence to drug therapy, blood sugar levels and complications associated with disease among Type 2 diabetic patients. J Diabetes Metab 2014;5:369.
28. Polansky WH. Poor medication adherence in diabetes: What’s the problem? J Diabetes 2015;7:777-8.
29. Gast A, Mathes T. Medication adherence influencing factors-an (updated) overview of systematic reviews. Syst Rev 2019;8:112.
30. Aminde LN, Tindong M, Ngwasiri CA, Aminde JA, Njim T, FondongAA, et al. Adherence to antidiabetic medication and factors associated with non-adherence among patients with Type-2 diabetes melitus in two regional hospitals in Cameroon. BMC Endocr Disord 2019;19:35.
31. Almaghaslah D, Abdelrhman AK, Al-Masdaf SK, Majrashi LM, Matary BM, Asiri WM, et al. Factors contributing to non-adherence to insulin therapy among Type 1 and Type 2 diabetes mellitus patients in Asser region, Saudi Arabia. Biomed Res 2018;29:2090-5.
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How to Cite
DARMADA, P. D., and D. CATUR WULANDARI. “RELATION OF MEDICATION ADHERENCE TO THE INCIDENCE OF COMPLICATIONS IN TYPE 2 DIABETES MELLITUS PATIENTS”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 13, no. 12, Dec. 2020, pp. 177-81, doi:10.22159/ajpcr.2020.v13i12.39874.
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