Compliance with Medication amongst Persons with Diabetes Mellitus during the COVID-19 Pandemic, Kerala, India: A Cross Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. General Setting
2.3. Site Specific Settings, Sample Size, and Patient Interviews
2.4. Study Population and Study Period
2.5. Study Variables
2.6. Analysis
3. Results
3.1. Socio-Demographic, Clinical Characteristics, and Health Care Processes
3.2. Access and Compliance with DM Medication
3.3. Factors Associated with Poor Compliance with DM Medication
4. Discussion
5. Conclusions
Open Access Statement and Disclaimer
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Open Access Statement and Disclaimer
References
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Category | Variables | Number | (%) |
---|---|---|---|
Total | 560 | ||
Age group years | 19–45 | 65 | (12) |
46–69 | 404 | (72) | |
≥70 | 91 | (16) | |
Gender | Male | 228 | (41) |
Female | 332 | (59) | |
Education | No formal schooling | 42 | (8) |
School | 426 | (76) | |
University | 92 | (16) | |
Occupation | Unemployed | 322 | (58) |
Manual labourer | 98 | (18) | |
Other | 149 | (25) | |
Socio-economic status | Below poverty line | 351 | (63) |
Above poverty line | 209 | (37) | |
Marital status | Married | 540 | (96) |
Single | 20 | (4) | |
Comorbidity * | Hypertension | 264 | (47) |
Coronary heart disease | 58 | (10) | |
Stroke | 8 | (1) | |
Bronchial asthma | 20 | (4) | |
Dyslipidaemia | 216 | (39) | |
Thyroid disease | 59 | (11) | |
None | 188 | (34) | |
Smoking history | Current | 13 | (2) |
Past smoker | 19 | (4) | |
Non-smoker | 528 | (94) | |
Alcohol | Use in the last 12 months | 60 | (11) |
Smokeless tobacco | Use in the last one month | 22 | (4) |
Category | Variables | Number | (%) |
---|---|---|---|
Total | 560 | ||
Family history of DM | Positive family history | 186 | (33) |
Duration of DM treatment in years | <2 | 49 | (9) |
2–5 | 202 | (36) | |
≥6 | 309 | (55) | |
Type of DM treatment | Oral medication single | 142 | (25) |
Oral medication multiple | 232 | (41) | |
Oral medication and insulin | 139 | (25) | |
Insulin | 47 | (9) | |
Location of primary health facility | Urban | 276 | (49) |
Rural | 284 | (51) | |
Place of purchase of medicines | Government | 507 | (90) |
Private | 9 | (2) | |
Government and Private | 44 | (8) | |
Did the health worker explain | How to take medicines (response = Yes) | 521 | (93) |
The need to take medicines regularly (response = Yes) | 306 | (55) | |
Glycemic control **,† | Good | 169 | (32) |
Poor | 362 | (68) | |
Frequency of blood glucose tests | Once a month | 450 | (80) |
Once in two months | 53 | (9) | |
More than 2 months | 58 | (11) | |
Frequency of visit to PHC | Once a month | 503 | (90) |
Once in two months | 23 | (4) | |
More than 2 months | 34 | (6) |
Questions Asked to Persons with DM | Number Responding Yes | (%) |
---|---|---|
Total | 560 | |
Is DM a chronic disorder? | 489 | (87) |
Is glycemic control important? | 509 | (91) |
Do you know about target blood glucose levels? | 227 | (41) |
Do you know about symptoms of hypoglycaemia? | 386 | (69) |
Do you know how to manage hypoglycaemia? | 429 | (77) |
Do you know how to control blood glucose levels in DM? | 175 | (31) |
Questions Asked to Persons with DM | Number Responding Yes | (%) |
---|---|---|
Total | 560 | |
Could you get blood glucose tested during COVID-19 lockdown in 2021? | 447 | (80) |
Did you have COVID-19 confirmed by LFA/RT-PCR? | 68 | (12) |
Have you had COVID-19 vaccination—One dose only | 168 | (30) |
Have you had COVID-19 vaccination—Two doses | 337 | (60) |
At the time of the interview were you unvaccinated? | 55 | (10) |
Category | Variables | Total | Poor Medication Compliance | Crude Prevalence Ratio (95% CI) | Adjusted Prevalence Ratio (95% CI) | p-Value * | |
---|---|---|---|---|---|---|---|
n | (%) | ||||||
Total | 560 | 209 | (37) | ||||
Age group years | 19–45 | 65 | 30 | (46) | 1.3 (0.9, 1.8) | 1.4 (1.1, 1.9) | 0.02 |
46–69 | 404 | 142 | (35) | Ref | |||
≥70 | 91 | 37 | (41) | 1.2 (0.9, 1.5) | 0.9 (0.8, 1.3) | 0.97 | |
Occupation | Unemployed | 322 | 134 | (42) | 1.6 (1.1, 2.2) | 1.3 (0.9, 1.9) | 0.26 |
Manual labourers | 98 | 26 | (27) | Ref | |||
Others | 140 | 49 | (35) | 1.2 (0.9, 1.9) | 1.2 (0.8, 1.6) | 0.42 | |
Socio-economic | Below poverty line | 351 | 72 | (21) | Ref | ||
Above poverty line | 209 | 137 | (66) | 3.2 (2.5, 4.0) | 1.0 (0.9, 1.2) | 0.68 | |
Alcohol use | In last 12 months—Yes | 60 | 17 | (28) | Ref | ||
In last 12 months—No | 500 | 192 | (38) | 1.4 (0.9, 2.1) | 0.9 (0.7, 1.4) | 0.87 | |
Type of DM treatment | Oral medication single | 142 | 70 | (49) | 1.7 (1.0, 2.7) | 1.5 (0.9, 2.1) | 0.06 |
Oral medication multiple | 232 | 82 | (35) | 1.2 (0.7, 1.9) | 1.3 (0.9, 1.8) | 0.26 | |
Oral medication + insulin | 139 | 43 | (31) | 1.0 (0.6, 1.7) | 1.2 (0.8, 1.8) | 0.44 | |
Insulin only | 47 | 14 | (30) | Ref | |||
Place of purchase of medicines | Government | 507 | 178 | (35) | Ref | ||
Private | 9 | 5 | (56) | 1.3 (0.7, 2.5) | 1.3 (0.8, 2.1) | 0.32 | |
Government/Private | 44 | 26 | (59) | 1.7 (1.3, 2.2) | 1.1 (0.9, 1.5) | 0.23 | |
Did health worker explain | How to take medicines—Yes | 521 | 190 | (37) | Ref | ||
How to take medicines—No | 39 | 19 | (49) | 1.3 (0.9, 1.9) | 0.9 (0.7, 1.3) | 0.63 | |
Frequency of blood glucose tests | Once a month | 450 | 159 | (35) | 1.0 (0.7, 1.5) | 1.3 (0.8, 1.9) | 0.27 |
Once in 2 months | 52 | 18 | (35) | Ref | |||
More than 2 months | 58 | 32 | (55) | 1.6 (1.0, 2.5) | 1.1 (0.7, 1.7) | 0.56 | |
Frequency of visits to PHC | Once a month | 503 | 177 | (35) | 1.0 (0.6, 1.8) | 0.8 (0.5, 1.4) | 0.52 |
Once in 2 months | 23 | 8 | (35) | Ref | |||
More than 2 months | 34 | 24 | (71) | 2.0 (1.1, 3.7) | 0.9 (0.5, 1.7) | 0.89 | |
Questions to Patients about DM | |||||||
Blood glucose control | Important—Yes | 509 | 183 | (36) | Ref | ||
Important—No | 51 | 26 | (51) | 1.4 (1.1, 1.9) | 1.1 (0.8, 1.5) | 0.61 | |
Can you control blood glucose levels | Yes | 175 | 58 | (33) | Ref | ||
Partially | 368 | 141 | (38) | 1.2 (0.9, 1.5) | 0.9 (0.7, 1.1) | 0.26 | |
No | 17 | 10 | (59) | 1.8 (1.1, 2.8) | 1.1 (0.7, 1.8) | 0.66 | |
Questions to Patients about COVID-19 | |||||||
Was blood glucose tested | During the pandemic—Yes | 447 | 109 | (24) | Ref | ||
During the pandemic—No | 113 | 100 | (89) | 3.6 (3.0, 4.3) | 3.6 (2.9, 4.3) | <0.001 | |
Have you had COVID-19 | Yes | 68 | 20 | (29) | Ref | ||
No | 492 | 189 | (38) | 1.3 (0.9, 1.9) | 1.4 (1.0, 1.9) | 0.03 | |
Have you had COVID-19 vaccination | Did not receive vaccine | 55 | 20 | (36) | Ref | ||
Received one dose | 168 | 71 | (42) | 1.2 (0.8, 1.7) | 1.5 (1.1, 2.1) | 0.012 | |
Received two doses | 337 | 118 | (35) | 0.9 (0.7, 1.4) | 1.4 (1.1, 2.0) | 0.024 |
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Jaya, A.M.; Harries, A.D.; Rahman, A.; Khogali, M.; Chinnakali, P.; Gopal, B. Compliance with Medication amongst Persons with Diabetes Mellitus during the COVID-19 Pandemic, Kerala, India: A Cross Sectional Study. Trop. Med. Infect. Dis. 2022, 7, 104. https://doi.org/10.3390/tropicalmed7060104
Jaya AM, Harries AD, Rahman A, Khogali M, Chinnakali P, Gopal B. Compliance with Medication amongst Persons with Diabetes Mellitus during the COVID-19 Pandemic, Kerala, India: A Cross Sectional Study. Tropical Medicine and Infectious Disease. 2022; 7(6):104. https://doi.org/10.3390/tropicalmed7060104
Chicago/Turabian StyleJaya, Ajan Maheswaran, Anthony D. Harries, Anisur Rahman, Mohammed Khogali, Palanivel Chinnakali, and Bipin Gopal. 2022. "Compliance with Medication amongst Persons with Diabetes Mellitus during the COVID-19 Pandemic, Kerala, India: A Cross Sectional Study" Tropical Medicine and Infectious Disease 7, no. 6: 104. https://doi.org/10.3390/tropicalmed7060104