Abstract
BACKGROUND: Diabetes Mellitus is a growing public health concern in Saudi Arabia, with effective management relying on adherence to medications and lifestyle changes. However, non-adherence remains a significant challenge, particularly in regions with varying sociodemographic profiles. OBJECTIVE: This study aimed to identify factors influencing adherence to medication and refills among patients with Type 2 Diabetes Mellitus in the Al-Ahsa region using the Adherence to Refills and Medications Scale. METHODS: A cross-sectional study was conducted from May to July 2024 involving 732 T2DM patients attending governmental primary healthcare centers in Al-Ahsa. A stratified random sampling method was employed to select participants from various geographic strata. Data were collected via structured phone interviews using a validated questionnaire, and clinical data were extracted from medical records. Descriptive statistics, chi-square tests, and multivariable logistic regression were applied to assess factors associated with non-adherence. RESULTS: The overall adherence rate was 52.5%. Significant sociodemographic factors (p < 0.05) associated with adherence included income, marital status, occupation, and area of residence. Clinical factors included age at diabetes onset, diabetic complications, HbA1c level, frequency of glucose monitoring, and comorbidities. Healthcare-related factors such as physician continuity, frequency of visits, and counseling were also significant. Multivariable logistic regression identified major predictors of non-adherence: living in the Southern region (OR = 6.59, p = 0.001), diabetic complications (OR = 1.44, p = 0.047), lack of physician counseling (OR = 2.15, p = 0.005), and poor access to healthcare (OR = 2.34, p = 0.003). CONCLUSION: Nearly half of T2DM patients in Al-Ahsa were non-adherent to medications and refills. Sociodemographic, clinical, and healthcare system factors significantly influenced adherence. Improving patient education, physician communication, and healthcare access may enhance adherence and outcomes.