Prevalence of poor medication adherence in type 2 diabetics in North Africa. Systematic review and meta-analysis.

INTRODUCTION

Medication adherence is the cornerstone of the successful drug management of a chronic disease.

AIM

To develop a systematic review and meta-analysis of the prevalence and the factors associated with non-adherence in patients with type 2 diabetes in North African countries.

METHODS

A literature search was conducted on Medline via Pubmed with a complementary search on Google Scholar. The meta-analysis was conducted using the Metaprop function of R software. The Cochrane Q test and Higgins I² statistic were used to estimate the heterogeneity.

RESULTS

In total, 16 studies measuring the prevalence of medication adherence in North African countries were selected in this systematic review. The combined prevalence of non-adherence was 38% (95% CI 30%-47%) with a random-effects model. The meta-analysis revealed a significant heterogeneity between studies (I² = 96%, p <0.01). Factors associated with non-adherence in type 2 diabetics were education level, social security coverage, therapeutic education, cost of medication, socioeconomic level, the duration of diabetes, unbalanced diabetic diet, polypharmacy, female gender, family support and age.

CONCLUSION

The combined prevalence of non-adherence among type 2 diabetics in North Africa was high and multifactorial, requiring global and integrated management by patients, physicians and pharmacists.