Determinants of medication adherence and knowledge among patients with Type 2 diabetes mellitus: A cross-sectional study in Northwestern China

Abstract

Objectives The study aimed to evaluate medication knowledge and adherence among patients with type 2 diabetes mellitus (T2DM) in northwestern China, identify factors influencing adherence, and examine the role of medication knowledge in adherence behavior. Methods This hospital-based,cross-sectional study was conducted at Xi’an People’s Hospital (Xi’an Fourth Hospital) from February to May 2025. A total of 510 adult patients with T2DM were enrolled. Medication knowledge and adherence were assessed using “diabetes medication knowledge questionnaire (DMKQ)” and “general medication adherence scale (GMAS)”, respectively. Multiple linear regression analysis was employed to identify independent risk factors associated with adherence. Results The study revealed that 53.93% of patients achieved satisfactory medication adherence, while 58.04% possessed adequate medication knowledge. Forgetfulness or difficulty remembering medication schedules was the most frequently reported barrier to adherence. Notably, a substantial proportion of patients were unaware of potential medication side effects, and nearly half lacked sufficient knowledge on managing adverse effects. Multiple linear regression analysis identified gender (B = 0.564, P  = 0.039), education level (B = 0.565, P  = 0.032), living conditions (B = 0.776, P  = 0.004), duration of antidiabetic drugs used (B = −0.046, P  = 0.009) and medication knowledge (B = 1.318, P  < 0.001) as independent factors of medication adherence, with medication knowledge exhibiting the strongest association (Beta = 0.533). Furthermore, a significant positive correlation was observed between medication knowledge and adherence. Conclusion Patients with diabetes in northwestern China often demonstrate suboptimal levels of both medication knowledge and adherence. As medication knowledge positively affects medication adherence, healthcare providers should assume a more proactive role in delivering comprehensive medication education to this patient population.