Insulin therapy adherence and its associated factors among diabetic patients in a Ghanaian primary care hospital

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Sefah, Israel Abebrese and Mensah, Michael and Hutton-Nyameaye, Araba Ata and Sarkodie, Emmanuel and Meyer, Johanna C. and Godman, Brian and Bangalee, Varsha (2025) Insulin therapy adherence and its associated factors among diabetic patients in a Ghanaian primary care hospital. PLoS ONE, 20 (1). e0312094. ISSN 1932-6203 (https://doi.org/10.1371/journal.pone.0312094)

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Abstract

Background: Diabetes mellitus (DM) is a global health problem. Adherence to intensive insulin therapy is necessary to achieve better glycemic control in types 1 and 2 DM. This study aimed to evaluate the extent of adherence to insulin therapy, its predictors and to identify barriers to its adherence. Method: This was a cross-sectional survey among adult (≥18 years) diabetic patients who are currently using insulin, either alone or in combination with an oral antidiabetic regimen, and seeking primary care at Kwame Nkrumah University of Science and Technology Hospital in Ghana. A total of one hundred and eight-six patients were conveniently sampled, and interviewed. Insulin adherence was determined using the Medication Adherence Reporting Scale-5. Descriptive statistics, a chi-square test of independence, and a multiple logistic regression analysis were performed using STATA version 14 (StataCorp, TX USA). Results: The majority of the patients interviewed were over 60 years (40.32%); female (61.83%); married (68.82%); and had completed secondary education (48.39%). 67.20% of the patients were adherent to insulin therapy. Adherence level was associated with age (p = 0.020), marital status (p = 0.001), employment status (p = 0.012), type of DM (p

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