Adherence to Recommended Regimen and Associated Factors among Type 2 Diabetes Mellitus Patients in Rwinkwavu District Hospital, Rwanda

Background 
The main risk factor for developing various complications and hospital admissions among type 2 diabetes is poor adherence to all recommended regimens. 
Objective 
To determine adherence to recommended regimen and associated factors among type 2 diabetes at Rwinkwavu District Hospital and its catchment area. 
Methods 
A descriptive cross-sectional study was employed. A total of 307 type 2 diabetes were selected using systematic random sampling. Data were collected using a questionnaire. Descriptive analysis (frequency and percentages) to describe the participants’ characteristics, and Chi-square test to establish associated factors with adherence to recommended regimen were performed. Then multivariable logistic regression was used to determine factors independently associated with adherence to recommended regimen. 
Results 
The result shows that 85.7%, 27.0% and 38.8% of the respondents had good adherence to medication, diet and exercise respectively. Multivariable analysis revealed that not taking alcohol [aOR= 2.21; 95%CI= 1.11-4.42], accessibility of healthcare services [aOR= 2.59; 95%CI= 1.21-5.53] and no experience of drug side effects [aOR= 5.27; 95%CI= 2.46-11.32] were associated with high medication adherence. Factors associated with high adherence level to recommended diet were accessibility to healthcare services [aOR= 2.93; 95%CI= 1.20-7.17], receiving lifestyle modification sessions [aOR= 3.56; 95%CI= 1.02-12.46] and presence of chronic comorbidities [aOR= 2.36; 95%CI= 1.37-4.08]. In addition, higher level of education [aOR= 2.64; 95%CI= 1.05-6.67], accessibility to healthcare services [aOR= 2.83; 95%CI= 1.31-6.09] and shorter time since diagnosis of type 2 diabetes [aOR= 2.09; 95%CI= 1.08-4.51] were more likely to have high adherence to recommended exercise. 
Conclusion 
Different individual and clinical factors were identified as determinants of adherence to recommended regimen among type 2 diabetes patients. Therefore, the policy makers concerned with health promotion will need to consider ways of improving access to compressive lifestyle education and healthcare services as well as availing drugs with less side effects. 
Rwanda J Med Health Sci 2022;5(3):276-290 
 