Prevalence and factors associated with medication adherence among diabetes patients in rural sub-district health facilities in Bangladesh

Medication adherence is critical for improving chronic disease outcomes, particularly diabetes mellitus. The prevalence of medication adherence among people with diabetes in rural communities is largely unknown. This study aimed to identify the prevalence and associated factors of medication adherence across sub-district healthcare facilities in Bangladesh. This cross-sectional study included 389 diabetic patients from non-communicable disease corners (NCDsC) of four health facilities in Bangladesh, between September and December 2023. Participants were ≥ 18 years old and diagnosed as DM by a registered physician and/or receiving anti-diabetic medication for at least six months. Independent variables included socio-demographic characteristics, behavioural characteristics, clinical history, and treatment status. Medication adherence was identified using the Morisky medication adherence scale (MMAS-8) (© 2006 Donald E. Morisky), and logistic regression analysis was performed to establish associated factors of medication adherence. The prevalence of high medication adherence was 40.4% (95% CI 35.6–45.3), and low medication adherence was 33.2% (95% CI 28.6–38). High medication adherence was significantly associated with recommended exercise (aOR: 1.78, 95% CI 1.12–2.83; p = 0.015), frequent (at least three within preceding three months) NCDsC visits (aOR: 1.86, 95% CI 1.20–2.86; p = 0.005), and blood glucose levels (aOR: 1.84, 95% CI 1.18–2.86; p = 0.005) after adjusting relevant confounders. Maintaining a controlled glycaemic status, frequent visits within the preceding three months, and engaging in recommended physical activity are strongly associated with high medication adherence. These findings will help government, and policymakers design strategies for higher medication adherence, mitigating risks, and managing NCDs in rural communities, thus improving health outcomes.