Prevalence of Insulin Adherence and the Associated Factors among Patients with Type 2 Diabetes Mellitus at Queen Elizabeth II Hospital, Sabah

Non-adherence to prescribed insulin treatments is the utmost important therapeutic problem to be resolved among patients with type 2 diabetes mellitus (T2DM). Inadequate adherence could elevate the progression of the disease, reduces the effectiveness of diabetes treatment and leads to early morbidity, poor quality of life, and imposes a significant burden on both the individual patient and the health care system. This study aims to examine factors influencing insulin adherence among patients with T2DM at the Diabetes Clinic, Queen Elizabeth II Hospital (QEH II). A cross-sectional study was conducted among T2DM outpatients who were on insulin treatments alone or combined with oral antidiabetic drugs (OADs) in the Diabetes Clinic, Queen Elizabeth II Hospital. Data were collected via self-administered validated questionnaires using Medication Compliance Questionnaire (MCQ), Health Belief Model (HBM) Diabetes Scale, and Patient Health Questionnaire (PHQ-8). A total of 360 patients took part in this study. The majority were female (n=218, 60.6%) whose age ranged from 28 – 87 years (54.07 ± 13.62 years). There was a significant correlation between insulin adherence with all the HBM constructs. The identified factors that affected the HBM constructs towards insulin adherence were age, years of diagnosed diabetes, duration on insulin injection, insulin regimens, diabetes complications, and depressive symptoms. Overall, the perceived benefits, depression, and self-efficacy predicted 51.6% of the variance in insulin adherence. Keywords: T2DM, insulin adherence, barriers, perceptions and beliefs, depressio