Association between medication regimen complexity and glycemic control among patients with type 2 diabetes mellitus at Debre Birhan Comprehensive and Specialized Hospital, Northeast Ethiopia

Abstract Type 2 diabetes mellitus (T2DM) is a metabolic disease that requires continuous medical care. Attaining glycemic control in patients with T2DM usually requires more complicated medication regimens. Increased medication regimen complexity (MRC) may affect glycemic control. This study aimed to assess the complexity of medication regimens and its association with glycemic control among patients with T2DM at the Debre Birhan Comprehensive and Specialized Hospital (DBCSH). A hospital-based cross-sectional study was conducted at DBCSH from April 30 to July 30, 2025. Medication Regimen Complexity Index (MRCI), a 65-item validated tool, was used to assess MRC. MRCI scores were calculated using Microsoft Access Version 1.0. Glycemic control was assessed using fasting blood glucose (FBG), as HbA1c measurement was not available in the study setting. The data were analyzed using SPSS version 27. A p-value of less than 0.05 at a 95% confidence interval was considered a significant variable in multivariable analysis. A total of 370 patients with T2DM were included in the final analysis. More than half of the patients were female (56.5%). About 30% of the participants were classified as having a high diabetes-specific MRCI, whereas 27.3% of the participants were classified as having high patient-specific MRCI. Compared with low MRCI, moderate diabetes-specific MRCI (AOR = 2.2; 95% CI = 1.1–4.1), moderate patient-specific MRCI (AOR = 3.4; 95% CI = 1.5–5.3), and high patient-specific MRCI (AOR = 6.6; 95% CI = 2.8–15.6) were significantly associated with poor glycemic control. The findings of this study showed that patients with T2DM have high medication regimen complexity. It also revealed that moderate diabetes-specific MRC and moderate and high patient-specific MRC were significantly associated with poor glycemic control. Further prospective cohort studies are needed to determine the temporal relationship between medication regimen complexity and glycemic control.