The Interplay of Health-System Barriers, Patient Knowledge, and Socioeconomic Factors in Predicting Diabetes Management Compliance: A Cross-Sectional Study in a Resource-Limited Setting.

This cross-sectional study investigated the determinants of compliance with dietary and medication regimens among 647 diabetic patients in a resource-constrained setting. The study aimed to assess the prevalence of health-system barriers, the level of patient knowledge, and their collective impact on self-management behaviors. Data were collected using structured questionnaires and analyzed using descriptive statistics, chi-square tests, and binary logistic regression. Findings revealed significant health-system barriers, with the cost of medications (M=3.61) being the most prominent. High health-system barriers were significantly associated with poor dietary (χ²=18.624, p<0.001) and medication compliance (χ²=24.351, p<0.001). Similarly, inadequate knowledge was a strong predictor of non-compliance for both diet (χ²=36.812, p<0.001) and medication (χ²=31.445, p<0.001). Multivariate analysis identified inadequate knowledge (AOR=2.84), high socio-cultural barriers (AOR=2.65), no formal education (AOR=2.14), low monthly income (AOR=1.89), and high health-system barriers (AOR=1.77) as significant independent predictors of poor dietary compliance. A similar model for medication compliance confirmed the robustness of these predictors. The study concludes that non-compliance is a multifactorial issue driven by an interplay of educational, socio-economic, cultural, and health-system factors. It underscores the imperative for integrated, multi-level interventions that simultaneously address structural health system deficiencies, provide targeted patient education, and mitigate the underlying social determinants of health to improve diabetes outcomes.

Diabetes Mellitus, Medication Adherence

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