Factors Influencing Medication Adherence Among Type 2 Diabetes Patients: A Cross-Sectional Study in Najran
Main Article Content
Keywords
MARS-5, medication adherence, type 2 diabetes (T2D)
Abstract
Achieving good glycemic control and preventing early complications are crucial goals in diabetes management, contingent upon patient adherence to prescribed regimens. Despite significant advancements in medication development, achieving optimal glycemic control remains challenging. This study aimed to evaluate medication adherence and associated factors among type 2 diabetes (T2D) patients at Najran
Methods: A cross-sectional study involving 245 T2D patients receiving care. Data on medication adherence were collected using the Medication Adherence Reporting Scale-5 (MARS-5). Statistical analysis was performed using SPSS version 21, with significance set at p < .05.
Results: The study found that only 29.4% (95% CI: 23.7%–35.1%) of respondents adhered to their diabetes medication. After adjusting for confounding factors such as khat chewing and adherence to blood glucose testing, factors associated with good medication adherence included being married (AOR = 3.43, 95% CI: 1.27–4.86), government employment (AOR = 3.75, 95% CI: 2.12–7.37), abstaining from alcohol (AOR = 2.25, 95% CI: 1.32–3.45), absence of comorbidities (AOR = 1.49, 95% CI: 1.16–4.32), and receiving diabetes health education at a healthcare institution (AOR = 3.43, 95% CI: 1.27–4.86).
Conclusion: The study highlights a notably low proportion of T2D patients adhering to their medication in the study area. Factors such as marital status, employment type, alcohol consumption, comorbidities, and access to diabetes health education were significantly associated with medication adherence. These findings underscore the importance of regular health education on medication adherence during patient follow-up visits and the need for broader awareness campaigns through mass media platforms
References
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11. Azodo, C. C., & Omuemu, V. O. (2017). Perception of spirituality, spiritual care, and barriers to the provision of spiritual care among undergraduate nurses in the University of Lagos, Nigeria. Journal of Clinical Sciences, 14(1), 119–125. DOI: 10.4103/jcls.jclss
12. Bekele, B. B., Bogale, B., Negash, S., et al. (2021). Public health interventions on prescription redemptions and secondary medication adherence among type 2 diabetes patients: Systematic review and meta-analysis of randomized controlled trials. Journal of Diabetes & Metabolic Disorders, 20, 1933–1956. DOI: 10.1007/s40200-021-00878-0
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14. Bruce, S. P., Acheampong, F., & Kretchy, I. (2015). Adherence to oral anti-diabetic drugs among patients attending a Ghanaian teaching hospital. Pharmacy Practice, 13(1), 533. DOI: 10.18549/PharmPract.2015.01.533
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21. Kumar, H., Amara Abdulla, R., & Lalwani, H. (2021). Medication adherence among type 2 diabetes mellitus patients: A cross-sectional study in rural Karnataka (India). Athens Journal of Health and Medical Sciences, 8(2), 107–118. DOI: 10.30958/ajhms.8-2-2
22. Lee, C. S., Tan, J. H. M., Sankari, U., Koh, Y. L. E., & Tan, N. C. (2017). Assessing oral medication adherence among patients with type 2 diabetes mellitus treated with polytherapy in a developed Asian community: A cross-sectional study. BMJ Open, 7(9), 1–7. DOI: 10.1136/bmjopen-2017-016317
23. Mannan, A., Hasan, M. M., Akter, F., Rana, M. M., Chowdhury, N. A., Rawal, L. B., & Biswas, T. (2021). Factors associated with low adherence to medication among patients with type 2 diabetes at different healthcare facilities in southern Bangladesh. Global Health Action, 14(1), 1872895. DOI: 10.1080/16549716.2021.1872895
24. Marcum, Z. A., & Gellad, W. F. (2012). Medication adherence to multi-drug regimens. Clinics in Geriatric Medicine, 28, 287–300. DOI: 10.1016/j.cger.2012.01.008
25. Mesfin, Y., Assegid, S., & Beshir, M. (2017). Medication Adherence among Type 2 diabetes ambulatory patients in Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Epidemiology: Open Access, 7(5), 322–334. DOI: 10.4172/2161-1165.1000322
26. Mirghani, H. O. (2019). An evaluation of adherence to anti-diabetic medications among type 2 diabetic patients in a Sudanese outpatient clinic. Pan African Medical Journal, 34, 1–9. DOI: 10.11604/pamj.2019.34.34.15161
27. Mroueh, L., Ayoub, D., El-Hajj, M., Awada, S., Rachidi, S., Zein, S., & Al-Hajje, A. (2018). Evaluation of medication adherence among Lebanese diabetic patients. Pharmacy Practice, 16(4), 1–8. DOI: 10.18549/PharmPract.2018.04.1291
28. Nashat Hegazy, N. (2017). Quality of care and medication adherence among patients with type 2 diabetes mellitus. The Egyptian Family Medicine Journal, 1(2), 1–13. DOI: 10.21608/efmj.2019.67587
29. Nonogaki, A., Heang, H., Yi, S., Van Pelt, M., & Yamashina, H. (2019). Factors associated with medication adherence among people with diabetes mellitus in poor urban areas of Cambodia: A cross-sectional study. PLoS One, 14(11), e0225000. DOI: 10.1371/journal.pone.0225000
30. Olorunfemi, O., & Ojewole, F. (2019). Medication belief as correlate of medication adherence among patients with diabetes in Edo State, Nigeria. Nursing Open, 6(1), 197–202. DOI: 10.1002/nop2.199
31. Raimi, T. H. (2017). Factors influencing medication adherence among patients with diabetes mellitus and hypertension in Nigeria. European Journal of Biology and Medical Science Research, 5(7), 18–26. Link
32. Rana, M. M., Islam, M. S., Akter, J., & Khatun, S. (2019). Medication adherence to type 2 diabetic patients hospitalized at a tertiary care hospital. Journal of Health Sciences, 9(3), 159–167. DOI: 10.17532/JHSCI.2019.818
33. Rezaie, F., Laghousi, D., & Alizadeh, M. (2019). Medication adherence and associated factors among type II diabetic patients in east Azerbaijan, Iran. Turkish Journal of Endocrinology and Metabolism, 23(3), 158–167. DOI: 10.25179/tjem.2019-65597
34. Rwegerera, G. M., Moshomo, T., Gaenamong, M., Oyewo, T. A., Gollakota, S., Mhimbira, F. A., Fadare, J., Godman, B., Meyer, J. C., & Rivera, Y. P. (2018). Antidiabetic medication adherence and associated factors among patients in Botswana; implications for the future. Alexandria Journal of Medicine, 54(2), 103–109. DOI: 10.1016/j.ajme.2017.01.005
35. Sabaté, E. (2003). WHO Adherence to Long Term Therapies Project, Global Adherence Interdisciplinary Network, World Health Organization. Dept. of Management of Noncommunicable Diseases. Adherence to long-term therapies: evidence for action. World Health Organization.
36. Sheleme, T., Mamo, G., Melaku, T., & Sahilu, T. (2020). Glycemic control and its predictors among adult diabetic patients attending Mettu Karl Referral Hospital, Southwest Ethiopia: A prospective observational study. Diabetes Therapy, 11(8), 1775–1794. DOI: 10.1007/s13300-020-00861-7
37. Teklay, G., Hussien, J., & Tesfaye, D. (2013). Non-adherence and associated factors among T2DM patients at Jimma University Specialized Hospital, Southwest Ethiopia. Journal of Medical Sciences, 13(7), 578–584. DOI: 10.3923/jms.2013.578.584
38. Thapar, R., Holla, R., Kumar, N., Aithal, S., Karkera, S., Rao, C., Pujari, N., Zahida, A., Unnikrishnan, B., Mithra, P., Swamy, D. K., Kulkarni, V., Bhagawan, D., & Kumar, A. (2020). Factors influencing adherence to anti-diabetes medications among type 2 diabetes patients attending tertiary care hospitals in Mangaluru. Clinical Epidemiology and Global Health, 8(4), 1089–1093. DOI: 10.1016/j.cegh.2020.03.025
39. Wabe, N. T., Angamo, M. T., & Hussein, S. (2011). Medication adherence in diabetes mellitus and self-management practices among type-2 diabetics in Ethiopia. North American Journal of Medical Sciences, 3(9), 418–423. DOI: 10.4297/najms.2011.3418
40. World Health Organization. (2019). Classification of Diabetes Mellitus, WHO
41. Wu, J.-R., Lennie, T. A., Chung, M. L., Frazier, S. K., Dekker, R. L., Biddle, M. J., & Moser, D. K. (2012). Medication adherence mediates the relationship between marital status and cardiac event-free survival in patients with heart failure. Heart & Lung, 41(2), 107–114. DOI: 10.1016/j.hrtlng.2011.09.009
42. Yamane, T. (1967). Statistics: An Introductory Analysis. (2nd editio).
43. Yosef, T. (2021). Hypoglycemia among type 1 diabetes patients after insulin use in southwest Ethiopia. Frontiers in Endocrinology, 12, 684570. DOI: 10.3389/fendo.2021.684570
44. Yosef, T., Nureye, D., & Tekalign, E. (2021). Poor glycemic control and its contributing factors among type 2 diabetes patients at Adama Hospital Medical College in East Ethiopia. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 3273–3280. DOI: 10.2147/DMSO.S321756
45. Yusuff, K. B., Obe, O., & Joseph, B. Y. (2008). Adherence to anti-diabetic drug therapy and self-management practices among type-2 diabetics in Nigeria. Pharmacy World & Science, 30(6), 876–883. DOI: 10.1007/s11096-008-9243-2
46. Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88. DOI: 10.1038/nrendo.2017.151
47. Zhou, Z., Huang, Z., Chen, B., Zheng, C., & Chen, W. (2019). Association between medication adherence and treatment satisfaction among patients with type 2 diabetes in Guangdong Province, China. Advances in Intelligent Systems Research, 165(Smont), 253–257. DOI: 10.2991/smont-19.2019.56
2. Adisa, R., Fakeye, T. O., & Fasanmade, A. (2011). Medication adherence among ambulatory patients with type 2 diabetes in a tertiary healthcare setting in Southwestern Nigeria. Pharmacy Practice (Internet), 9(2), 72–81. DOI: 10.4321/s1886-36552011000200003
3. Ahmed, A. T., Karter, A. J., & Liu, J. (2006). Alcohol consumption is inversely associated with adherence to diabetes self-care behaviours. Diabetic Medicine, 23(7), 795–802. DOI: 10.1111/j.1464-5491.2006.01878.x
4. Almadhoun, M. R., & Alagha, H. Z. (2018). Assessment of medication adherence and its association with glycemic control among type-2 diabetes mellitus patients in Gaza-Palestine. Clinical and Experimental Pharmacology, 8(3), e0207583. DOI: 10.4172/2161-1459.1000250
5. Aloudah, N. M., Scott, N. W., Aljadhey, H. S., Araujo-Soares, V., Alrubeaan, K. A., & Watson, M. C. (2018). Medication adherence among patients with type 2 diabetes: A mixed methods study. PLoS One, 13(12), 1–18. DOI: 10.1371/journal.pone.0207583
6. Alqarni, A. M., Alrahbeni, T., Al Qarni, A., & Al Qarni, H. M. (2019). Adherence to diabetes medication among diabetic patients in the Bisha governorate of Saudi Arabia – a cross-sectional survey. Patient Preference and Adherence, 13, 63–71. DOI: 10.2147/PPA.S176355
7. Alshehri, K. A., Altuwaylie, T. M., Alqhtani, A., Albawab, A. A., & Almalki, A. H. (2020). Type 2 diabetic patients adherence towards their medications. Cureus, 12(December 2017), 1–6. DOI: 10.7759/cureus.6932
8. Aminde, L. N., Tindong, M., Ngwasiri, C. A., Aminde, J. A., Njim, T., Fondong, A. A., & Takah, N. F. (2019). Adherence to anti-diabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocrine Disorders, 19(1), 1–9. DOI: 10.1186/s12902-019-0360-9
9. Asheq, A., Ashames, A., Al-Tabakha, M., Hassan, N., & Jairoun, A. (2021). Medication adherence in type 2 diabetes mellitus patients during Covid-19 pandemic: A cross-sectional study from the United Arab Emirates. F1000Research, 10, 435. DOI: 10.12688/f1000research.51729.2
10. Awodele, O., & Osuolale, J. A. (2015). Medication adherence in type 2 diabetes patients: Study of patients in Alimosho General Hospital, Igando, Lagos, Nigeria. African Health Sciences, 15(2), 513–522. DOI: 10.4314/ahs.v15i2.26
11. Azodo, C. C., & Omuemu, V. O. (2017). Perception of spirituality, spiritual care, and barriers to the provision of spiritual care among undergraduate nurses in the University of Lagos, Nigeria. Journal of Clinical Sciences, 14(1), 119–125. DOI: 10.4103/jcls.jclss
12. Bekele, B. B., Bogale, B., Negash, S., et al. (2021). Public health interventions on prescription redemptions and secondary medication adherence among type 2 diabetes patients: Systematic review and meta-analysis of randomized controlled trials. Journal of Diabetes & Metabolic Disorders, 20, 1933–1956. DOI: 10.1007/s40200-021-00878-0
13. Benrazavy, L., & Ali, K. (2019). Medication adherence and its predictors in type 2 diabetic patients referring to urban primary health care centers in Kerman City, southeastern Iran. Shiraz E Medical Journal, 20(7), e84746. DOI: 10.5812/semj.84746
14. Bruce, S. P., Acheampong, F., & Kretchy, I. (2015). Adherence to oral anti-diabetic drugs among patients attending a Ghanaian teaching hospital. Pharmacy Practice, 13(1), 533. DOI: 10.18549/PharmPract.2015.01.533
15. Centers for Disease Control and Prevention (2021). Education and Support. CDC.
16. Cho, N., Shaw, J., Karuranga, S., et al. (2018). IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice, 138, 271–281. DOI: 10.1016/j.diabres.2018.02.023
17. DiMatteo, M. R. (2004). Variations in patients’ adherence to medical recommendations: A quantitative review of 50 years of research. Medical Care, 42(3), 200–209. DOI: 10.1097/01.mlr.0000114908.90348.f9
18. Farsaei, S., Sabzghabaee, A. M., Zargarzadeh, A. H., & Amini, M. (2011). Adherence to glyburide and metformin and associated factors in type 2 diabetes in Isfahan, Iran. Iranian Journal of Pharmaceutical Research, 10, 933–939.
19. Feda, M. A., Faidah, N. N., Allam, A. T., Aloithimen, B. A., Alsharif, A. A., Alqarni, M. A., Saeedi, A. Y. S., Felemban, B. N. H., Awan, H. M., Alansari, M. A., Khayat, N. A., Alharbi, F. A., Bakhsh, A. Y. A., & Bugis, E. A. H. (2022). Medication adherence among geriatric patients with chronic diseases while living alone. Journal of Pharmaceutical Negative Results, 13(8), 832–842. DOI: 10.47750/pnr.2022.13.S08.105
20. Imran, M., & Plathottam, J. J. (2017). A study on treatment adherence among patients with type 2 diabetes mellitus attending diabetic clinic. International Journal of Community Medicine and Public Health, 4(5), 1701. DOI: 10.18203/2394-6040.ijcmph20171787
21. Kumar, H., Amara Abdulla, R., & Lalwani, H. (2021). Medication adherence among type 2 diabetes mellitus patients: A cross-sectional study in rural Karnataka (India). Athens Journal of Health and Medical Sciences, 8(2), 107–118. DOI: 10.30958/ajhms.8-2-2
22. Lee, C. S., Tan, J. H. M., Sankari, U., Koh, Y. L. E., & Tan, N. C. (2017). Assessing oral medication adherence among patients with type 2 diabetes mellitus treated with polytherapy in a developed Asian community: A cross-sectional study. BMJ Open, 7(9), 1–7. DOI: 10.1136/bmjopen-2017-016317
23. Mannan, A., Hasan, M. M., Akter, F., Rana, M. M., Chowdhury, N. A., Rawal, L. B., & Biswas, T. (2021). Factors associated with low adherence to medication among patients with type 2 diabetes at different healthcare facilities in southern Bangladesh. Global Health Action, 14(1), 1872895. DOI: 10.1080/16549716.2021.1872895
24. Marcum, Z. A., & Gellad, W. F. (2012). Medication adherence to multi-drug regimens. Clinics in Geriatric Medicine, 28, 287–300. DOI: 10.1016/j.cger.2012.01.008
25. Mesfin, Y., Assegid, S., & Beshir, M. (2017). Medication Adherence among Type 2 diabetes ambulatory patients in Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Epidemiology: Open Access, 7(5), 322–334. DOI: 10.4172/2161-1165.1000322
26. Mirghani, H. O. (2019). An evaluation of adherence to anti-diabetic medications among type 2 diabetic patients in a Sudanese outpatient clinic. Pan African Medical Journal, 34, 1–9. DOI: 10.11604/pamj.2019.34.34.15161
27. Mroueh, L., Ayoub, D., El-Hajj, M., Awada, S., Rachidi, S., Zein, S., & Al-Hajje, A. (2018). Evaluation of medication adherence among Lebanese diabetic patients. Pharmacy Practice, 16(4), 1–8. DOI: 10.18549/PharmPract.2018.04.1291
28. Nashat Hegazy, N. (2017). Quality of care and medication adherence among patients with type 2 diabetes mellitus. The Egyptian Family Medicine Journal, 1(2), 1–13. DOI: 10.21608/efmj.2019.67587
29. Nonogaki, A., Heang, H., Yi, S., Van Pelt, M., & Yamashina, H. (2019). Factors associated with medication adherence among people with diabetes mellitus in poor urban areas of Cambodia: A cross-sectional study. PLoS One, 14(11), e0225000. DOI: 10.1371/journal.pone.0225000
30. Olorunfemi, O., & Ojewole, F. (2019). Medication belief as correlate of medication adherence among patients with diabetes in Edo State, Nigeria. Nursing Open, 6(1), 197–202. DOI: 10.1002/nop2.199
31. Raimi, T. H. (2017). Factors influencing medication adherence among patients with diabetes mellitus and hypertension in Nigeria. European Journal of Biology and Medical Science Research, 5(7), 18–26. Link
32. Rana, M. M., Islam, M. S., Akter, J., & Khatun, S. (2019). Medication adherence to type 2 diabetic patients hospitalized at a tertiary care hospital. Journal of Health Sciences, 9(3), 159–167. DOI: 10.17532/JHSCI.2019.818
33. Rezaie, F., Laghousi, D., & Alizadeh, M. (2019). Medication adherence and associated factors among type II diabetic patients in east Azerbaijan, Iran. Turkish Journal of Endocrinology and Metabolism, 23(3), 158–167. DOI: 10.25179/tjem.2019-65597
34. Rwegerera, G. M., Moshomo, T., Gaenamong, M., Oyewo, T. A., Gollakota, S., Mhimbira, F. A., Fadare, J., Godman, B., Meyer, J. C., & Rivera, Y. P. (2018). Antidiabetic medication adherence and associated factors among patients in Botswana; implications for the future. Alexandria Journal of Medicine, 54(2), 103–109. DOI: 10.1016/j.ajme.2017.01.005
35. Sabaté, E. (2003). WHO Adherence to Long Term Therapies Project, Global Adherence Interdisciplinary Network, World Health Organization. Dept. of Management of Noncommunicable Diseases. Adherence to long-term therapies: evidence for action. World Health Organization.
36. Sheleme, T., Mamo, G., Melaku, T., & Sahilu, T. (2020). Glycemic control and its predictors among adult diabetic patients attending Mettu Karl Referral Hospital, Southwest Ethiopia: A prospective observational study. Diabetes Therapy, 11(8), 1775–1794. DOI: 10.1007/s13300-020-00861-7
37. Teklay, G., Hussien, J., & Tesfaye, D. (2013). Non-adherence and associated factors among T2DM patients at Jimma University Specialized Hospital, Southwest Ethiopia. Journal of Medical Sciences, 13(7), 578–584. DOI: 10.3923/jms.2013.578.584
38. Thapar, R., Holla, R., Kumar, N., Aithal, S., Karkera, S., Rao, C., Pujari, N., Zahida, A., Unnikrishnan, B., Mithra, P., Swamy, D. K., Kulkarni, V., Bhagawan, D., & Kumar, A. (2020). Factors influencing adherence to anti-diabetes medications among type 2 diabetes patients attending tertiary care hospitals in Mangaluru. Clinical Epidemiology and Global Health, 8(4), 1089–1093. DOI: 10.1016/j.cegh.2020.03.025
39. Wabe, N. T., Angamo, M. T., & Hussein, S. (2011). Medication adherence in diabetes mellitus and self-management practices among type-2 diabetics in Ethiopia. North American Journal of Medical Sciences, 3(9), 418–423. DOI: 10.4297/najms.2011.3418
40. World Health Organization. (2019). Classification of Diabetes Mellitus, WHO
41. Wu, J.-R., Lennie, T. A., Chung, M. L., Frazier, S. K., Dekker, R. L., Biddle, M. J., & Moser, D. K. (2012). Medication adherence mediates the relationship between marital status and cardiac event-free survival in patients with heart failure. Heart & Lung, 41(2), 107–114. DOI: 10.1016/j.hrtlng.2011.09.009
42. Yamane, T. (1967). Statistics: An Introductory Analysis. (2nd editio).
43. Yosef, T. (2021). Hypoglycemia among type 1 diabetes patients after insulin use in southwest Ethiopia. Frontiers in Endocrinology, 12, 684570. DOI: 10.3389/fendo.2021.684570
44. Yosef, T., Nureye, D., & Tekalign, E. (2021). Poor glycemic control and its contributing factors among type 2 diabetes patients at Adama Hospital Medical College in East Ethiopia. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 3273–3280. DOI: 10.2147/DMSO.S321756
45. Yusuff, K. B., Obe, O., & Joseph, B. Y. (2008). Adherence to anti-diabetic drug therapy and self-management practices among type-2 diabetics in Nigeria. Pharmacy World & Science, 30(6), 876–883. DOI: 10.1007/s11096-008-9243-2
46. Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88. DOI: 10.1038/nrendo.2017.151
47. Zhou, Z., Huang, Z., Chen, B., Zheng, C., & Chen, W. (2019). Association between medication adherence and treatment satisfaction among patients with type 2 diabetes in Guangdong Province, China. Advances in Intelligent Systems Research, 165(Smont), 253–257. DOI: 10.2991/smont-19.2019.56
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Dec 21, 2023
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Abdul Rahman Masoud Ali Al Zabid, Hadi Hashal Al Zubaid, Saleh Hashel Hassan, Hashel Hassan ALzubaid, Waleed Masoud Ali Zubayd , NOUH HUSSAIN SALEH ALYAMI, Yassir Hassan Saleh Al Zubayd , Ali Hashal AL Zubayd, Alhussain Mohammed Hawkash. (2023). Factors Influencing Medication Adherence Among Type 2 Diabetes Patients: A Cross-Sectional Study in Najran . Journal of Population Therapeutics and Clinical Pharmacology, 30(18), 339-349. https://mail.jptcp.com/index.php/jptcp/article/view/4760
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Abdul Rahman Masoud Ali Al Zabid, Hadi Hashal Al Zubaid, Saleh Hashel Hassan, Hashel Hassan ALzubaid, Waleed Masoud Ali Zubayd , NOUH HUSSAIN SALEH ALYAMI, Yassir Hassan Saleh Al Zubayd , Ali Hashal AL Zubayd, Alhussain Mohammed Hawkash. (2023). Factors Influencing Medication Adherence Among Type 2 Diabetes Patients: A Cross-Sectional Study in Najran . Journal of Population Therapeutics and Clinical Pharmacology, 30(18), 339-349. https://mail.jptcp.com/index.php/jptcp/article/view/4760