Medication Adherence Among Patients With Type 2 Diabetes at the Upper West Regional Hospital, Ghana

Background The prevalence of type 2 diabetes mellitus (T2DM) has risen rapidly in low‐ and middle‐income countries, including Ghana, and poor adherence to glucose‐lowering medications undermines glycemic control and increases risk of complications. Aim To identify health‐system, socio‐demographic, and socio‐economic factors associated with glucose‐lowering medication adherence among adults with type 2 diabetes attending outpatient follow‐up at the Upper West Regional Hospital, Ghana. Methods We conducted a hospital‐based cross‐sectional study at the Upper West Regional Hospital, Ghana between 20 February and 8 March 2024. Consecutive eligible adults (≥ 18 years) with a clinical diagnosis of T2DM and at least 3 months of self‐reported medication use were recruited using convenience sampling. The sample comprised N = 202 participants. Trained research assistants administered an electronic questionnaire (Google Forms) that included the 8‐item Morisky Medication Adherence Scale (MMAS‐8). Bivariate associations were tested with Chi‐square tests, and multivariable binary logistic regression (reporting adjusted odds ratios, AOR, with 95% CIs) was used to identify factors associated with adherence. Analyses were performed in SPSS v20 and two‐sided p < 0.05 was considered statistically significant. Results Overall, 51.5% of participants were classified as having poor medication adherence. Several socio‐economic and health factors were significantly associated with adherence using the chi‐square test of associations. In unadjusted logistic regression analysis, participants on drug treatment for < 6 months had higher odds of good adherence compared with those on treatment ≥ 6 months (COR: 3.70 95% CI: (1.50–8.97; p = 0.004) as well as those who spent more than 200 Ghana cedis monthly on drugs (COR: 36.30 95% CI: 10.88–121.1; p = 0.001) compared with those who spent less than 50 Ghana cedis on a monthly basis and participants who were diagnosed between 1 and 3 years (COR: 19.17 95% CI: 6.35–57.86; p = 0.001) and greater than 3 years (COR: 14.52 95% CI: 4.61–45.759; p = 0.001) had better odds of adherence compared to those diagnosed in less than a year. In age, education and monthly income adjusted multivariable models, none of these variables showed a significant association with medication adherence. Conclusions A substantial proportion of adults with T2DM attending outpatient follow‐up at the Upper West Regional Hospital demonstrated poor self‐reported adherence to glucose‐lowering medications. Interventions that strengthen patient education, address medication side‐effects and affordability, and improve clinician follow‐up should be prioritized. The cross‐sectional design of this study and further reliance on self‐reported medication adherence (MMAS‐8) are important limitations.