Open Access Highly Accessed Research article

Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 diabetes: a cross-sectional study

Farzana Saleh1*, Shirin J Mumu2, Ferdous Ara1, Md Abdul Hafez3 and Liaquat Ali4

Author Affiliations

1 Department of Community Nutrition, Bangladesh University of Health Sciences (BUHS), 125/1 Darussalam Mirpur-1, Dhaka-1216, Bangladesh

2 Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh

3 Department of Biostatistics, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh

4 Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh

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BMC Public Health 2014, 14:431  doi:10.1186/1471-2458-14-431

Published: 7 May 2014



Non-adherence to lifestyle modification among diabetic patients develops the short-term risks and the long-term complications as well as declines the quality of life. This study aimed to find out the association between non-adherence to self-care practices, medication and health related quality of life (HR-QoL) among type 2 diabetic patients.


At least 1 year diagnosed patients with type 2 diabetes (N = 500), age>25 years were conveniently selected from the Out-Patient Department of Bangladesh Institute of Health Sciences Hospital. Patients’ self-care practices were assessed via interviewer-administered questionnaires using an analytical cross-sectional design. HRQoL was assessed by an adapted and validated Bangla version of the EQ-5D (EuroQol Group, 2009) questionnaire which has five domains- mobility, self-care, usual activities, pain/discomfort and anxiety/depression and two levels on each dimension. EQ-5D responses were further translated into single summery EQ-5D index using UK TTO value set. Patients’ were considered as non-adhered to self-care practices according to the guidelines of Diabetic Association of Bangladesh. Multivariable linear regression was used to assess the association between non-adherence towards self-care practices and HRQoL.


Among the study patients, 50.2% were females and mean ± SD age was 54.2 (±11.2) years. Non-adherence rate were assessed for: blood glucose monitoring (37%), diet (44.8%), foot care (43.2%), exercise (33.2%) and smoking (37.2%). About 50.4% patients had problem in mobility, 28.2% in self-care, 47.6% in usual activities, 72.8% in pain/discomfort and 73.6% in anxiety/depression. On chi-squared test, significant association was found between non adherence to foot care and problem with mobility, self-care and usual activities (p < 0.05). Significant association was also found between non-adherence to exercise and poor mobility, self- care, usual activities, pain and anxiety (p < 0.05). Non-adherence to diet was associated with poor mobility (p < 0.05). In multivariable linear regression non-adherence to foot care (p = 0.0001), exercise (p = 0.0001), and smoking (p = 0.047) showed significant association with EQ-5D index after adjusting co-variates.


In this study, patients who have a non-adherence rate also have a lower quality of life.

Non-adherence; Self-care practices; Medication; Health related quality of life; Bangladesh; Type 2 diabetes