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<p>Medication non-adherence may affect hospital outcomes in patients with uncontrolled diabetes mellitus (DM), but inpatient data remain limited. This study evaluated medication non-adherence, causes of admission, and length of stay (LOS), and identified factors associated with medication non-adherence and LOS among admissions involving patients with uncontrolled DM. A retrospective observational study was conducted among adult admissions with uncontrolled DM to medical wards between January and June 2024. Data was extracted from medical records. Medication regimen complexity was assessed using the Medication Regimen Complexity Index (MRCI). Medication adherence was assessed as per documentation by pharmacists or medical officers. Univariable, multivariable logistic regression, and linear regression analyses were performed to identify factors associated with medication non-adherence and LOS. A total of 326 admissions were included. Among admissions with documented adherence data, 55.2% were classified as non-adherent. Infections (33.4%) and cardiovascular disorders (27.3%) were the most common causes of admission. Higher MRCI (aOR 1.131, 95% CI 1.071–1.195, <i>p</i> &lt; 0.001), female gender (aOR 2.071, 95% CI 1.011–4.240, <i>p</i> = 0.047), and Chinese ethnicity (aOR 4.215, 95% CI 1.385–12.825, <i>p</i> = 0.011) were associated with medication non-adherence. Each additional target organ damage (TOD) was associated with approximately 24.0% longer LOS (95% CI 5.4–45.7%, <i>p</i> = 0.010). In this single-centre inpatient sample, medication non-adherence was prevalent and associated with higher medication regimen complexity. Higher TOD burden contributed to prolonged hospitalisation. These findings highlight the need for structured adherence assessment and multidisciplinary strategies to optimise treatment and prevent long-term diabetes complications.</p>

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Medication non-adherence, admission causes, and length of stay among patients with uncontrolled diabetes mellitus in a Malaysian tertiary hospital

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  • 发表日期：

    2026年8月4日

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  • Denise Faith Msowoya,
  • Mahmathi Karuppannan,
  • Shamala Balan,
  • Kavidha Mohan

摘要

Medication non-adherence may affect hospital outcomes in patients with uncontrolled diabetes mellitus (DM), but inpatient data remain limited. This study evaluated medication non-adherence, causes of admission, and length of stay (LOS), and identified factors associated with medication non-adherence and LOS among admissions involving patients with uncontrolled DM. A retrospective observational study was conducted among adult admissions with uncontrolled DM to medical wards between January and June 2024. Data was extracted from medical records. Medication regimen complexity was assessed using the Medication Regimen Complexity Index (MRCI). Medication adherence was assessed as per documentation by pharmacists or medical officers. Univariable, multivariable logistic regression, and linear regression analyses were performed to identify factors associated with medication non-adherence and LOS. A total of 326 admissions were included. Among admissions with documented adherence data, 55.2% were classified as non-adherent. Infections (33.4%) and cardiovascular disorders (27.3%) were the most common causes of admission. Higher MRCI (aOR 1.131, 95% CI 1.071–1.195, p < 0.001), female gender (aOR 2.071, 95% CI 1.011–4.240, p = 0.047), and Chinese ethnicity (aOR 4.215, 95% CI 1.385–12.825, p = 0.011) were associated with medication non-adherence. Each additional target organ damage (TOD) was associated with approximately 24.0% longer LOS (95% CI 5.4–45.7%, p = 0.010). In this single-centre inpatient sample, medication non-adherence was prevalent and associated with higher medication regimen complexity. Higher TOD burden contributed to prolonged hospitalisation. These findings highlight the need for structured adherence assessment and multidisciplinary strategies to optimise treatment and prevent long-term diabetes complications.