Adherence To Diabetes Care Management and Quality of Life Among Diabetic Persons in Ibadan, Oyo State, Nigeria

Abstract

Diabetes is a challenging health problem that threatens the quality of life of an affected person. It is a progressively increasing metabolic disorder that demands global attention due to its interference with quality of life (QOL). While existing knowledge has established that, diabetes impairs an individual’s well-being and overall QOL; not many studies have focused on the impact of treatment adherence to diabetes management on QOL. Information about QOL and treatment adherence is useful in implementing and evaluating interventions in the management of diabetes.

A descriptive cross-sectional study, with approval obtained from the ethical review committee of the Oyo State Ministry of Health, Nigeria. Purposive sampling was used to select 300 respondents. The interviewer-administered questionnaire contains information on socio-demographics, clinical determinants, adherence to treatment, and QOL. The QOL instrument was adapted from the WHO–QOL bref questionnaire, adherence to treatment from the Morisky treatment adherence tool, and reviewed literature. The data was analyzed using SPSS, with p-value <0.05. Descriptive statistics such as frequencies and percentages explained socio-demographic variables. Associations between selected variables and QOL were explained with inferential statistics. The mean QOL scores were calculated in domains according to the WHOQOL scale. Respondents consisted of 15 type I diabetic patients and 285 type II diabetic patients. Respondent's mean age was 58.77 + 8.51 predominantly females (79.7%) and 58% were Christians. Majority of the respondents were employed (59%) and earned more than 20,000 naira (17.6%). Most of the respondents had uncontrolled blood sugar (58%). The respondents' mean age at onset of diabetes is between age 30 and 60 years (53.28+9.55) with more cases of type II diabetes. Domain-specific quality of life scores is higher in the environmental domain (58.04+ 11.01) as compared to other QOL domains. Also, the study identified forgetfulness as the main reason for non-compliance to drug prescriptions among the respondents.

About 20% skipped their appointment with the physician, while 86.7% followed a diabetic routine diet, and 28.6% engaged in mild to moderate exercise. Generally, patients who adhered to their treatment had controlled blood glucose with higher mean QOL scores in all the domains. The predictors of the QOL domains were identified as: medication adherence and psychological domain (p-value-0.018), age of the respondents and social domain (p-value-0.004), environmental domain and age at onset of diabetes (p-value-0.032); and monthly income is a significant predictor of all the domains of QOL. Conclusively, the mean quality of life domain scores informed average scores relating to patients' adherence to treatment. As such, treatment adherence predicts a good perception of QOL. Also, glycemic control amongst other clinical determinants is capable of influencing a good perception of QOL.