LIMITING FACTORS TO THERAPEUTIC ADHERENCE AMONG PATIENTS WITH TYPE II DIABETES MELLITUS AT THE NATIONAL HOSPITAL 2024-2025

Abstract

Introduction: Treatment adherence in patients with type 2 diabetes mellitus is a challenge for achieving adequate disease control. Lack of therapeutic compliance reduces treatment effectiveness, increases complications, and negatively affects quality of life, also representing a public health problem due to its clinical and economic impact. Objective: To determine the factors contributing to lack of treatment adherence among patients with type 2 diabetes mellitus hospitalized in the Department of Internal Medicine at the National Hospital during the 2024-2025 period. Methodology: An observational, descriptive, cross-sectional study was conducted among patients aged ≥18 years with type 2 diabetes mellitus and at least one year of disease duration. Sociodemographic and clinical variables were collected. Medication adherence was assessed using the Morisky-Green-Levine test, while barriers were evaluated using the Adherence Barriers Questionnaire. Descriptive statistics were applied, as well as Pearson's chi-square test or Fisher's exact test, considering p<0.05 as statistically significant. Results: A total of 119 patients were included. The mean age was 58.3 ± 10.5 years, with a predominance of males (58%) and urban residence (80.6%). Arterial hypertension was the most frequent comorbidity (82.4%). The mean glycated hemoglobin level was 9.5 ± 2.6%, and diabetic foot was the main cause of hospitalization (90.8%). Low or moderate adherence was observed in 73.9% of patients. The main barriers were forgetfulness (96.6%), depressive symptoms (85.7%), and medication costs (73.9%). A significant association was identified between higher educational level and better adherence (p=0.002). Conclusion: Lack of therapeutic adherence in this population is mainly associated with emotional, economic, and behavioral factors. It is essential to implement interventions that include the detection of depressive symptoms, strengthening of health literacy, and ensuring continuous access to medications, in order to improve metabolic control and reduce chronic complications.