Factors associated with treatment regimen adherence of patients with Type2 diabetes in sari in 2021

Background & Aims: Diabetes is one of the most common chronic diseases, which is associated with many complications. It also increases the economic burden and medical costs for the individual, family, and community. Prevention of complications of diabetes and its successful control requires the patient's participation in treatment and adherence to the treatment regimen. Adherence to a diabetes treatment regimen is a complex process that includes changes in diet planning, exercise, blood sugar monitoring, and medication intake. Despite the importance of adhering to a treatment regimen, adherence is not complete. Non-compliance has many individual and social consequences. Adherence Improvement leads to mortality reduction and success in the treatment of diabetes. Treatment regimen adherence is influenced by various factors. Considering that adherence to the treatment regimen is challenging among diabetics and little attention has been paid to it in Iran; therefore, the present study aims to identify the related factors to treatment regimen adherence. Materials & Methods: This cross-sectional descriptive study was conducted –from February to June, 2021 with 226 adults with Type 2 diabetes referred to a clinic of Mazandaran University of Medical Sciences in Sari, continuously and based on inclusion criteria: having an age of 18 to 65 years, Reading and writing ability, no pregnancy, no psychiatric disorder, no severe visual or hearing impairment. Data were collected using a demographic characteristics questionnaire exploring participants' age, gender, level of education, marital status, occupation, level of education, economic status, duration of diagnosis, and BMI. In addition, the valid and reliable The Diabetes Activities Questionnaire (TDAQ) was used to measure treatment regimen adherence. Questionnaires were distributed electronically through Google Forms. The link was provided to the research participants through WhatsApp OR Telegram software. To comply with ethical considerations, after obtaining permission from the ethics committee of Iran University of Medical Sciences, along with obtaining informed consent from the participants, They were also assured about the confidentiality of their information. They were free to leave the study whenever they wished, and if desired, the research results would be available to them. After data collection, Data analysis was performed in SPSS version 26 using descriptive statistics (frequency distribution, mean and standard deviation) and inferential statistics (independent t-test, analysis of variance, Pearson correlation coefficient). Results: The mean age of participants was 53.06 ± 10.81. In this study, most participants were female (61.9%), married (85.8%), with a diploma (26.5%), with average economic status (69%), and housewives (45.1%). Also, the mean BMI of the participants was 29.14 ± 5.55. The results showed that the total score of Treatment regimen adherence with a mean of 903.71 and the standard deviation was 259.64 With a score range of 20-1300. The results of the one-way ANOVA test showed that economic status is significantly related to Treatment regimen adherence. (P = 0.01, F = 4.35). The results of the Pearson correlation coefficient showed that there is a positive and significant relationship between Treatment regimen adherence and age. (P = 0.04, r = 0.13) also, There is a significant negative relationship between Treatment regimen adherence and BMI. (P = 0.01, r = 0.17). So people with better economic status, older age, and lower BMI had better treatment regimen adherence. There was also no significant relationship between gender, occupation, marital status, education, and duration of diabetes with Treatment regimen adherence. Conclusion: According to the results of the present study, it is necessary for health care providers, especially nurses, to pay attention to related factors of treatment adherence, while providing care and patient education to have better quality of care. At the same time, this study provides a basis for expanding knowledge in adherence to diabetes treatment regimens. Also, Considering that adherence to the treatment regimen was significantly related to the economic status, it is recommended policymakers provide better conditions for adherence to the treatment by reducing treatment costs and increasing access to services.