The impact of the COVID-19 lockdown on medication adherence in patients with type 2 diabetes in the Kingdom of Saudi Arabia

Abstract

Abstract Introduction: The COVID-19 outbreak and its restrictions significantly influence people’s health status and mental wellbeing globally. Patients with chronic illnesses such as diabetes are more vulnerable to the pandemic and its consequences. Partial and complete national lockdowns that have been imposed in Saudi Arabia to control the spread of the virus have caused changes in healthcare service utilisation, self-care of diabetes, and physiological status for patients with type 2 diabetes. These changes affect patients’ adherence to their diabetic medication and their glycaemic control. Research Objective: To evaluate the impact of the COVID-19 national lockdown on medication adherence for patients with type 2 diabetes in the Kingdom of Saudi Arabia. Methods and Subjects: A cross-sectional, quantitative prospective study was used to collect data from participants. An electronic questionnaire was distributed to citizen and resident adult patients with type 2 diabetes who attended either community or hospital pharmacies via WhatsApp in five different parts in Saudi Arabia. The survey included questions on patient demographics, medication adherence, self-diabetes care, difficulties with healthcare systems, and physiological status during the pandemic lockdown compared to pre-pandemic. Patients’ adherence to their therapeutic regimens during lockdown was assessed based on a count of weekly days. The difference between patients’ adherence levels before and during the lockdown was evaluated using the Wilcoxon test. The collected data were analysed using SPSS programme ver. 22. Results: A total of 137 Saudi and non-Saudi adult patients with type 2 diabetes engaged in the present study. The majority were male (n = 81). Most patients were Saudis (n = 112) with a university education (n = 73). Most patients were non-smokers (n = 93), had only one comorbidity (29.9%), and used oral hypoglycaemic medication (57.7%). Patients’ adherence to their diabetic medication significantly decreased during the national lockdown (5.20 ± 2.34) compared to pre-pandemic (5.47 ± 2.23; p < 0.01). ii Conclusion: Patients with type 2 diabetes demonstrated poor adherence to their medicines and uncontrolled blood glucose levels during the national lockdown in Saudi Arabia. Changing psychological states and missing follow-up visits were the main reasons for their reduction in adherence. Recommendations: Patients with type 2 diabetes should be encouraged to utilise online or virtual appointments during the lockdown to enhance their adherence to medication, assure optimal glycaemic control, and reduce diabetes-related complications.