Factors associated with treatment non-adherence among congolese patients with type 2 diabetes mellitus receiving care at the Brazzaville university hospital.

Abstract

Introduction: Non-adherence to treatment is a major challenge in the management of type 2 diabetes mellitus. The objective of this study was to investigate the factors associated with non-adherence to treatment among Congolese patients with type 2 diabetes mellitus being treated at the University Teaching Hospital of Brazzaville

Patients and Methods: An analytical cross-sectional study conducted from October 1, 2024, to June 30, 2025 a period of 9 months among patients with type 2 diabetes mellitus who had been receiving antidiabetic treatment for at least 6 months and were being treated at the Brazzaville University Hospital. Therapeutic adherence was measured using the Morisky scale.

Results: The study included 150 patients with a median age of 53 years (range: 46–60). The participants were 58.7% female and 41.3% male. The median duration of diabetes was 5.66 ± 3.45 years. The mean glycated hemoglobin was 8.26 ± 1.43%. Patients were treated with oral and non-insulin injectable antidiabetic agents (42.7%) and with insulin therapy alone (20%). Non-adherence to treatment was observed in 58% of cases. Factors associated with non-adherence to treatment were irregular diabetes follow-up (OR = 3.5; 95% CI [1.76–6.94]), polypharmacy (OR = 4.49; 95% CI [2.19–9.20]), financial difficulties (OR = 41.04; 95% CI [13.3–125.6]), erroneous social beliefs (OR = 12.8; 95% CI [5.85–28.34]), and the use of herbal medicine (OR = 10.8; 95% CI [4.7–24.8]).

Conclusion: Non-adherence to treatment among patients with type 2 diabetes at the University Teaching Hospital of Brazzaville remains high and is associated with multiple factors. It calls for a comprehensive management strategy that includes enhanced patient education, improved access to quality care.