Evaluation of the adherence to antidiabetic medications among Iraqi patients with T2DM using the Iraqi antidiabetic medication adherence scale (IADMAS)

Background and Aims: Management of diabetes is a multifactorial process, and adherence to treatment programs plays a role in glycemic control. The present study evaluates the adherence rate to the antidiabetic medications with a newly developed scale and patients' HbA1c levels among Iraqi patients with type-2 diabetes. Methods: A cross-sectional study among adult patients receiving diabetic care in public and private healthcare settings within Baghdad City was conducted. The medication adherence was evaluated using the Iraqi Antidiabetic Medication Adherence Scale (IADMAS) to determine the factors associated with non-adherence to anti-diabetic medications. Glycated hemoglobin (HbA1c) levels of the participants were used as an indicator of glycemic status. Results: The outcome measures include the comparison between glycemic status and the claims of antidiabetic medication adherence of patients with T2DM, in addition to the expected benefits to clinical practice. A total of 442 patients with type 2 diabetes participated in the study and responded by completing the given questionnaire (response rate: 96.1%). The prevalence of non-adherence to medication was reported to be no more than 30%. Adherence based on HbA1c values reflected a high false-positive value of adherence with an extremely high true negative value. The adherence of Iraqi patients to their medications demonstrated a high negative predictive value (0.905) and a high sensitivity (0.928) with low specificity (0.156) values. Conclusion: The use of IADMAS in this study failed to confirm the consistency between the apparent claims of adherence to anti-diabetic medications and the HbA1c value as a marker of glycemic control. Keywords: T2DM, antidiabetic medications, patient adherence, IADMAS