title: Treatment non-adherence among patients with poorly controlled type 2 diabetes in ambulatory care settings in southwestern Nigeria.
abstract: BACKGROUND
  Poor adherence to prescribed therapy among patients with chronic diseases is a growing concern which undermines the benefits of current medical care.
  
  
  OBJECTIVE
  To evaluate the pattern of treatment non-adherence among ambulatory patients with poorly controlled type 2 diabetes in southwestern Nigeria, and to determine the possible factor(s) that accounted for such non-adherence with a view to identifying areas of future intervention to improve outcome.
  
  
  METHODS
  A prospective cross-sectional interview using the concept of RIM (Recognize, Identify and Manage) model was used to evaluate adherence to treatment recommendations among 176 consented patients recruited from the endocrinology out-patient clinics of two teaching hospitals in southwestern Nigeria between November, 2010 and January, 2011.
  
  
  RESULTS
  Overlaps of non-adherence behavior were obtained. More than three-quarter (153; 88.4%) were not aware of indication for each of the prescribed medications, 26 (15.3%) correctly described regimen as prescribed. The factorsidentified as possible barriers to medication adherence include practical (145; 40.1%), knowledge (103; 28.5%), and attitudinal (114; 31.5%) barriers. Dietary non-adherence was mostly due to inappropriate guidance (62; 33.7%).
  
  
  CONCLUSIONS
  The arrays of non-adherence behavior among the cohort further emphasize the need for patient-centered approach as a reasonable strategy in resolving non-adherence problems in routine clinical practice.
authors.affiliation: Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Nigeria.
authors.forename: Rasaq
authors.initials: R
authors.lastname: Adisa
authors.affiliation: Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Nigeria.
authors.forename: Titilayo O
authors.initials: TO
authors.lastname: Fakeye
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001786:Blood Glucose / Q000187:drug effects; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Ambulatory care; Non-adherence; Type 2 diabetes