Determinants of non-adherence to diabetes treatment among patients at Hawassa University Comprehensive Referral Hospital, Ethiopia.

BACKGROUND: Diabetes mellitus (DM) is a major metabolic disorder characterized by chronic hyperglycemia. Medication non-adherence remains a significant public health concern, particularly in sub-Saharan Africa, contributing to poor glycemic control and increased morbidity. METHODS: This study assessed adherence using a multi-method tool, including self-reporting, a visual analog scale, pill identification tests, and pill counts. Data were collected from patients enrolled in the diabetes follow-up program at Hawassa University, Ethiopia, between 2008 and 2021. Ordinal logistic regression analysis was used to identify factors associated with treatment non-adherence using naturally ordered categorical data. RESULTS: The multi-method tool revealed that patient adherence to antidiabetic drugs was 25.6% (low), 32.6% (moderate), and 41.8% (high). The analysis identified several significant predictors of adherence, including gender, depression frequency, knowledge about medication benefits, the quality of the relationship with care providers, the type of complications, satisfaction with care, educational level, and the frequency of participation in treatment decisions. CONCLUSIONS: Medication non-adherence remains a major challenge in diabetes management. Targeted interventions such as strengthening patient education, psychosocial support, and provider-patient communication, particularly for men and those with depressive symptoms, are essential to improve adherence and health outcomes.