Abdullah K. Rabba, Waleed S. Aljiris, Nehad J. Ahmed, Khalid M. Alkharfy


Objective: To assess the extent of antidiabetic drug adherence in patients with type 2 diabetes mellitus, and different factors affecting adherence in outpatient clinics in Alkharj city, Kingdom of Saudi Arabia.


Methodology: Type 2 diabetic patients attending two outpatient clinics in Alkharj city, KSA, were randomly selected, and interviewed for information regarding their antidiabetic drug adherence. A six-item questionnaire was used to measure the level of adherence in study participants. Participants scoring six points are categorized as (high adherent), while scores of 4 to 5 puts the participants in the (medium adherence) category, and participants with scores less than 4 are of (Low adherence). Patient’s records were also, reviewed, for relevant lab and clinical data.

Results: 68 type 2 diabetic patients participated in this study from April 2014 to September 2014. Majority of participants (73.5%) were of 40 to 60 years old. Hypertension and/or lipid disorders were encountered in majority of patients in this study. 

26.5% of patients in this study were categorized as (high adherent), 55.9% as (medium adherent), and 17.6% as (low adherent). 72% of patients had an HbA1c level of ≥7% suggesting poor control of their disease. Patients with a longer history of diabetes, and patients with HbA1c level less than 7%  found to achieve better adherence levels (p-value<0.05). 

Conclusion: Subjective information from patients suggested accepted level of adherence. Nevertheless, objective measurements of HbA1c, suggest poor glycemic control that possibly reflect poor adherence to antidiabetic medications.


Diabetes mellitus, Adherence, Non-adherence, Alkharj city, Saudi Arabia

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Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2•7 million participants. Lancet 2011;378:31–40.

Al-Nozha MM, Al-Maatouq MA, Al-Mazrou YY, Al-Harthi SS, Arafah MR, Khalil MZ, et al. Diabetes mellitus in Saudi Arabia. Saudi Med J 2004;25:1603–10.

Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, Yousef M, Sabico SL, et al. Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (Riyadh cohort 2): a decade of an epidemic. BMC Med 2011;9:76.

Alharbi NS, Almutari R, Jones S, Al-Daghri N, Khunti K, de Lusignan S. Trends in the prevalence of type 2 diabetes mellitus and obesity in the Arabian gulf states: systematic review and meta-analysis. Diabetes Res Clin Pract 2014;106:e30-3.

Al-Rubeaan K, Al-Manaa H, Khoja T, Ahmad N, Al-Sharqawi A, Siddiqui K, et al. The Saudi abnormal glucose metabolism and diabetes impact study (SAUDI-DM). Ann Saudi Med 2014;34:465–75.

Cramer JA, Roy A, Burrell A, Fairchild CJ, Fuldeore MJ, Ollendorf DA, et al. Medication compliance and persistence: terminology and definitions. Value Health 2008;11:44–7.

Adisa R, Alutundu MB, Fakeye TO. Factors contributing to nonadherence to oral hypoglycemic medications among ambulatory type 2 diabetes patients in Southwestern Nigeria. Pharm Pract (Granada) 2009;7:163–9.

Gelaw BK, Mohammed A, Tegegne GT, Defersha AD, Fromsa M, Tadesse E, et al. Nonadherence and contributing factors among ambulatory patients with antidiabetic medications in Adama Referral Hospital. J Diabetes Res 2014. 10.1155/2014/617041

Chung WW, Chua SS, Lai PSM, Chan SP. Effects of a pharmaceutical care model on medication adherence and glycemic control of people with type 2 diabetes. Patient Prefer Adherence 2014;8:1185–94.

Donnan PT, MacDonald TM, Morris AD. Adherence to prescribed oral hypoglycaemic medication in a population of patients with type 2 diabetes: a retrospective cohort study. Diabet Med 2002;19:279–84.

Hugtenburg JG, Timmers L, Elders PJ, Vervloet M, van Dijk L. Definitions, variants, and causes of nonadherence with medication: a challenge for tailored interventions. Patient Prefer Adherence 2013;7:675–82.

Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005;353:487–97.

Shams MEE, Barakat EAME. Measuring the rate of therapeutic adherence among outpatients with T2DM in Egypt. Saudi Pharm J 2010;18:225–32.

Girerd X, Hanon O, Anagnostopoulos K, Ciupek C, Mourad JJ, Consoli S. Assessment of antihypertensive compliance using a self-administered questionnaire: development and use in a hypertension clinic. Presse Med 2000;30:1044–8.

Hamooz‎ S, Sweileh W, Aker‎‏ O. Effect of “Polypharmacy” and “Frequency of drug dosing” on rate of compliance among diabetic and hypertensive patients: a survey study in palestine. An-Najah Univ J Res-Nat Sci 2003;17:155–65.

Al-Aujan S, Al-Aqeel S, Al-Harbi A, Al-Abdulltif E. Patients’ satisfaction with diabetes medications in one hospital, Saudi Arabia. Patient Prefer Adherence 2012;6:735–40.

Al-Hayek Aa, Robert Aa, Alzaid Aa, Nusair HM, Zbaidi NS, Al-Eithan MH, et al. Association between diabetes self-care, medication adherence, anxiety, depression, and glycemic control in type 2 diabetes. Saudi Med J 2012;33:681–3.

Khan AR, Al-Abdul Lateef ZN, Al Aithan MA, Bu-Khamseen MA, Al Ibrahim I, Khan SA. Factors contributing to non-compliance among diabetics attending primary health centers in the Al Hasa district of Saudi Arabia. J Family Community Med 2012;19:26–32.

Jarab AS, Almrayat R, Alqudah S, Thehairat E, Mukattash TL, Khdour M, et al. Predictors of non-adherence to pharmacotherapy in patients with type 2 diabetes. Int J Clin Pharm 2014;36:725–33.

Jarab AS, Alqudah SG, Mukattash TL, Shattat G, Al-Qirim T. Randomized controlled trial of clinical pharmacy management of patients with type 2 diabetes in an outpatient diabetes clinic in Jordan. J Manag Care Pharm 2012;18:516–26.

Jamous RM, Sweileh WM, Abu-Taha AS, Sawalha AF, Zyoud SH, Morisky DE. Adherence and satisfaction with oral hypoglycemic medications: a pilot study in palestine. Int J Clin Pharm 2011;33:942–8.

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986;24:67–74.

Roquer J, Giralt-Steinhauer E, Cerdà G, Rodríguez-Campello A, Cuadrado-Godia E, Jimenez-Conde J, et al. Glycated hemoglobin value combined with initial glucose levels for evaluating mortality risk in patients with ischemic stroke. Cerebrovasc Dis 2015;40:244–50.

Abebe SM, Berhane Y, Worku A, Alemu S, Mesfin N. Level of sustained glycemic control and associated factors among patients with diabetes mellitus in Ethiopia: a hospital-based cross-sectional study. Diabetes Metab Syndr Obes: Targets Ther 2015;8:65–71.

Fadare J, Olamoyegun M, Gbadegesin BA. Medication adherence and direct treatment cost among diabetes patients attending a tertiary healthcare facility in Ogbomosho, Nigeria. Malawi Med J 2015;27:65–70.

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Diabetes mellitus, Adherence, Non-adherence, Alkharj city, Saudi Arabia





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International Journal of Pharmacy and Pharmaceutical Sciences
Vol 9, Issue 11, 2017 Page: 247-250

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Authors & Affiliations

Abdullah K. Rabba
Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
Palestinian Territory, Occupied

Waleed S. Aljiris
Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
Saudi Arabia

Nehad J. Ahmed
Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia

Khalid M. Alkharfy
Department of Clinical Pharmacy, King Saud University, Riyadh, Saudi Arabia

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