Utilisation of Complementary Medicines and Adherence to Medications in Adults with Type 2 Diabetes

Abstract

Introduction: Globally, there has been an insurgence of utilisation of complementary among diabetic patients resulting in poor adherence to prescribed anti-diabetic medicines and poor glycaemic control. Research Design and Methods: This was a cross sectional survey conducted at the Harare Central Hospital which is a quaternary level of care centre serving mostly the northern population of the country. Participants were a consecutive sample of 211 patients aged 18 years and above, with Type II diabetes, on diabetic medications and had been diagnosed at least 6 months prior to the study. Adherence to medications was measured using the Medication Compliance Questionnaire while use of complementary medicines was measured using an adapted version of the International Complementary and Alternative Medicine Questionnaire (ICAM- Q Scale). Excluded from the study were the very ill, unconscious, institutionalised, mentally challenged and pregnant women. Approval was granted by the institutional and the national ethical review boards. All participants gave informed consent and strict confidentiality was maintained throughout the research process. Data was analysed using the Statistical Package for the Social Sciences version 21. Descriptive statistics, the Chisquare test and logistic regression were used to analyse the data. Results: Prevalence of use of complementary medicines was 40.1% and was associated with place of residence (p>0.023) and payment mode (p>0.025) while non-adherence to conventional medicines was 37.9% and was associated with income level (p>0.044) and employment status (p>0.050). There was a 6 times likelihood of non-adherence among users of complementary medicines compared to non-users (OR 0.41, p> 0.002, CI 0.23-0.73). Key findings: Use of complementary and alternative medicines is high among diabetic patients in other countries. The concurrent use of complementary medicines with prescribed medicines was high in our study and it negatively affected adherence to medications. The commonly cited reason was lack of finances. Psychosocial assessment and health education are key in the management of diabetes in resource limited settings to promote adherence. Conclusion: Use of complementary medicines was high and negatively affected adherence to prescribed medicines. There is need for health education on unsupervised use of complementary medicines and routine assessment of same among diabetic patients.