Research Article
BibTex RIS Cite

Evaluation of the adherence to antidiabetic medications among Iraqi patients with T2DM using the Iraqi antidiabetic medication adherence scale (IADMAS)

Year 2021, Volume: 51 Issue: 3, 307 - 312, 29.12.2021

Saad Abdulrahman Hussain Haydar Fakhri Al-tukmagi Zainab Saad Abdulrahman Maryem Maythem Sadeq Dania Natheer Hashim Rand Sabah Kadhim Mohammed Mahdi Muayad Kubba Dur Haydar Al-tukmagi

Abstract

Background and Aims: Management of diabetes is a multifactorial process, and adherence to treatment programs plays a role in glycemic control. The present study evaluates the adherence rate to the antidiabetic medications with a newly developed scale and patients’ HbA1c levels among Iraqi patients with type-2 diabetes. Methods: A cross-sectional study among adult patients receiving diabetic care in public and private healthcare settings within Baghdad City was conducted. The medication adherence was evaluated using the Iraqi Antidiabetic Medication Adherence Scale (IADMAS) to determine the factors associated with non-adherence to anti-diabetic medications. Glycated hemoglobin (HbA1c) levels of the participants were used as an indicator of glycemic status. Results: The outcome measures include the comparison between glycemic status and the claims of antidiabetic medication adherence of patients with T2DM, in addition to the expected benefits to clinical practice. A total of 442 patients with type 2 diabetes participated in the study and responded by completing the given questionnaire (response rate: 96.1%). The prevalence of non-adherence to medication was reported to be no more than 30%. Adherence based on HbA1c values reflected a high false-positive value of adherence with an extremely high true negative value. The adherence of Iraqi patients to their medications demonstrated a high negative predictive value (0.905) and a high sensitivity (0.928) with low specificity (0.156) values. Conclusion: The use of IADMAS in this study failed to confirm the consistency between the apparent claims of adherence to anti-diabetic medications and the HbA1c value as a marker of glycemic control.

Keywords

T2DM antidiabetic medications patient adherence IADMAS

Supporting Institution

Al-Rafidain University College, Faculty of Pharmacy, Baghdad, Iraq

Project Number

4/2019

Thanks

The authors thank Al-Rafidain University College for supporting the project

References

  • • Abebe, S. M., Berhane, Y. & Worku, A. (2014). Barriers to diabetes medication adherence in North West Ethiopia. SpringerPlus, 3(1), 195. https://doi:10.1186/2193-1801-3-195
  • • Ahmad, N. S., Ramli, A., Islahudin, F. & Paraidathathu, T. (2013). Medication adherence in patients with type 2 diabetes mellitus treated at primary health clinics in Malaysia. Patient Preference and Adherence, 7, 525-530. https://doi:10.2147/PPA.S44698
  • • American Diabetes Association. (2020). Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care, 43(Suppl. 1), S14-S31. https://doi:10.2337/dc20-S002
  • • Aminde, L. N., Tindong, M., Ngwasiri, C. A., Aminde, J. A., Njim, T., Fondong, A. A., & Takah, N. F. (2019). Adherence to antidiabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocrine Disorders, 19(1), 35. https:// doi:10.1186/s12902-019-0360-9
  • • Bagonza, J., Rutebemberwa, E. & Bazeyo, W. (2015). Adherence to anti-diabetic medication among patients with diabetes in eastern Uganda; a cross sectional study. BMC Health Services Research, 15(1), 168. https://doi:10.1186/s12913-015-0820-5
  • • Bertoni, A. G., Krop, J. S., Anderson, G. F. & Brancati, F. L. (2002). Diabetes-related morbidity and mortality in a national sample of U.S. elders. Diabetes Care, 25(3), 471-475. https://doi:10.2337/diacare. 25.3.471
  • • Bi, Y., Wang, T., Xu, M., Xu, Y., Li, M., Lu, J. …Ning, G. (2012). Advanced research on risk factors of type 2 diabetes. Diabetes Metabolism Research and Reviews, 28(Suppl. 2), 32-39. https:// doi:10.1002/dmrr.2352
  • • Capoccia, K., Odegard, P. S. & Letassy, N. (2016). Medication adherence with diabetes medication: a systematic review of the literature. The Diabetes Educator, 42(1), 34-71. https:// doi:10.1177/0145721715619038
  • • Chan, M. (2017). Obesity and diabetes: the slow-motion disaster. Milbank Quarterly, 95(1), 11-14. https://doi:10.1111/1468-0009.12238
  • • Chaudhury, A., Duvoor, C., Reddy Dendi, V. S., Kraleti, S., Chada, A., Ravilla, R. …Mirza, W. (2017). Clinical review of antidiabetic drugs: Implications for type 2 diabetes mellitus management. Frontiers in Endocrinology, 8, 6. https://doi:10.3389/fendo.2017.00006
  • • Chia, L. R., Schlenk, E. A. & Dunbar-Jacob, J. (2006). Effect of personal and cultural beliefs on medication adherence in the elderly. Drugs & Aging, 23(3), 191-202. https://doi:10.2165/00002512-200623030- 00002
  • • Chung, W. W., Chua, S. S., Lai, P. S. M. & Morisky, D. (2015). The Malaysian Medication Adherence Scale (MALMAS): concurrent validity using a clinical measure among people with type 2 diabetes in Malaysia. PLoS One, 10(4), e0124275. https://doi:10.1371/journal. pone.0124275
  • • de Vries McClintock, H. F., Morales, K. H., Small, D. S. & Bogner, H. R. (2016). Patterns of adherence to oral hypoglycemic agents and glucose control among primary care patients with type 2 diabetes. Behavioral Medicine, 42(2), 63-71. https://doi:10.1080/089642 89.2014.904767
  • • Del Brutto, O. H., & Mera, R. M. (2016). The importance of people compliance (social desirability bias) in the assessment of epilepsy prevalence in rural areas of developing countries. Results of the Atahualpa Project. Epilepsia, 57(12), e221-e224. https:// doi:10.1111/epi.13594
  • • Egede, L. E., Gebregziabher, M., Dismuke, C. E., Lynch, C. P., Axon, R. N., Zhao, Y. … Mauldin P. D. (2012). Medication nonadherence in diabetes: longitudinal effects on costs and potential cost savings from improvement. Diabetes Care, 35(Suppl. 1), 2533-2539. https://doi:10.2337/dc12-0572
  • • Egede, L. E., Gebregziabher, M., Echols, C. & Lynch, C. P. (2014). Longitudinal effects of medication nonadherence on glycemic control. Annals of Pharmacotherapy, 48(5), 562-570. https:// doi:10.1177/1060028014526362
  • • Forbes, J. M. & Cooper, M. E. (2013). Mechanisms of diabetic complications. Physiological Reviews, 93(1), 137-188. https:// doi:10.1152/physrev.00045.2011
  • • Grant, R. W. & Kirkman, M. S. (2015). Trends in the evidence level for the American Diabetes Association’s “Standards of Medical Care in Diabetes” from 2005 to 2014. Diabetes Care, 38(1), 6-8. https://doi:10.2337/dc14-2142
  • • Heissam, K., Abuamer, Z., & El-Dahshan, N. (2015). Patterns and obstacles to oral antidiabetic medications adherence among type 2 diabetics in Ismailia, Egypt: a cross section study. Pan African Medical Journal, 20, 177. https://doi:10.11604/pamj.2015.20.177.4025
  • • Ho, P. M., Rumsfeld, J. S., Masoudi, F. A., Reese, D., Linder, R., Ahrens, S. & Magid, D. J. (2006). Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Achieve of Internal Medicine, 166(17), 1836-1841. https:// doi:10.1001/archinte.166.17.1836
  • • Kaiser, A. B., Zhang, N. & Van der Pluijm, W. (2018). Global prevalence of type 2 diabetes over the next ten years (2018-2028). Diabetes, 67 (Suppl. 1), 202. https://doi.org/10.2337/db18-202-LB
  • • Krapek, K., King, K., Warren, S. S., George, K. G., Caputo, D. A., Mihelich, K., … Lubowski, T. J. (2004). Medication adherence and associated hemoglobin A1c in type 2 diabetes. Annals of Pharmacotherapy, 38(9), 1357-1362. https://doi:10.1345/aph.1D612
  • • Lingam, R., & Scott, J. (2002). Treatment non-adherence in affective disorders. Acta Psychiatrica Scandinavica, 105(3), 164-172. https://doi:10.1034/j.1600-0447.2002.1r084.x
  • • Mikhael, E. M., Hussain, S. A., Shawky, N. & Hassali, M. A. (2019). Validity and reliability of anti-diabetic medication adherence scale among patients with diabetes in Baghdad, Iraq: a pilot study. BMJ Open Diabetes Research & Care, 7(1), e000658. https://:doi:10.1136/ bmjdrc-2019-000658
  • • Musenge, E. M., Michelo, C., Mudenda, B., & Manankov, A. (2016). Glycaemic Control and Associated Self-Management Behaviours in Diabetic Outpatients: A Hospital Based Observation Study in Lusaka, Zambia. Journal of Diabetes Research, 2016, 1-9. https:// doi:10.1155/2016/7934654
  • • Nguyen, T. M. U., Caze, A. L. & Cottrell, N. (2014). What are validated self-report adherence scales measuring? a systematic review. British Journal of Clinical Pharmacology, 77(3), 427-445. https:// doi:10.1111/bcp.12194
  • • Ogurtsova, K., da Rocha Fernandes, J. D., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N. H. …Makaroff, L. E. (2017). IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Research and Clinical Practice, 128, 40-50. https:// doi:10.1016/j.diabres.2017.03.024
  • • Polonsky, W. H. & Henry, R. R. (2016). Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors. Patient Preference and Adherence, 2016, 1299- 1307. https://doi:10.2147/PPA.S106821
  • • Sarwar, N., Gao, P., Kondapally Seshasai, S. R., Gobin, R., Kaptoge, S. & Di Angelantonio, E. (2010). The Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet, 375(9733), 2215-2222. https:// doi.org/10.1016/S0140-6736(10)60484-9
  • • Schectman, J. M., Nadkarni, M. M. & Voss, J. D. (2002). The association between diabetes metabolic control and drug adherence in an indigent population. Diabetes Care, 25(6), 1015-1021. https:// doi:10.2337/diacare.25.6.1015
  • • Sodihardjo-Yuen, F., van Dijk, L., Wensing, M., De Smet, P. A. & Teichert, M. (2017). Use of pharmacy dispensing data to measure adherence and identify non-adherence with oral hypoglycemic agents. European Journal of Clinical Pharmacology, 73(2), 205-213. https://doi:10.1007/s00228-016-2149-3
  • • Stirratt, M. J., Dunbar-Jacob, J., Crane, H. M., Simoni, J. M., Czajkowski, S., Hilliardet, M. E. …Nilsen, W. J. (2015). Self-report measures of medication adherence behavior: recommendations on optimal use. Translational Behavioral Medicine, 5(4), 470-482. https://doi:10.1007/s13142-015-0315-2
  • • Stolar, M. (2010). Glycemic control and complications in type 2 diabetes mellitus. American Journal of Medicine, 123(Suppl. 3), S3- S11. https://doi:10.1016/j.amjmed.2009.12.004
  • • Whooley, M. A., Avins, A. L., Miranda, J. & Browner, W. S. (1997). Case-finding instruments for depression. Two questions are as good as many. Journal of General Internal Medicine, 12(7), 439-445. https://doi:10.1046/j.1525-1497.1997.00076.x
  • • Wilke, T., Groth, A., Mueller, S., Reese, D., Linder, R., Ahrens, S. & Frank Verheyen, F. (2013). How to use pharmacy claims data to measure patient nonadherence? The example of oral diabetics in therapy of type 2 diabetes mellitus. The European Journal of Health Economics, 14(3), 551-568. https://doi:10.1007/s10198- 012-0410-y

Year 2021, Volume: 51 Issue: 3, 307 - 312, 29.12.2021

Saad Abdulrahman Hussain Haydar Fakhri Al-tukmagi Zainab Saad Abdulrahman Maryem Maythem Sadeq Dania Natheer Hashim Rand Sabah Kadhim Mohammed Mahdi Muayad Kubba Dur Haydar Al-tukmagi

Abstract

Project Number

4/2019

References

  • • Abebe, S. M., Berhane, Y. & Worku, A. (2014). Barriers to diabetes medication adherence in North West Ethiopia. SpringerPlus, 3(1), 195. https://doi:10.1186/2193-1801-3-195
  • • Ahmad, N. S., Ramli, A., Islahudin, F. & Paraidathathu, T. (2013). Medication adherence in patients with type 2 diabetes mellitus treated at primary health clinics in Malaysia. Patient Preference and Adherence, 7, 525-530. https://doi:10.2147/PPA.S44698
  • • American Diabetes Association. (2020). Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care, 43(Suppl. 1), S14-S31. https://doi:10.2337/dc20-S002
  • • Aminde, L. N., Tindong, M., Ngwasiri, C. A., Aminde, J. A., Njim, T., Fondong, A. A., & Takah, N. F. (2019). Adherence to antidiabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocrine Disorders, 19(1), 35. https:// doi:10.1186/s12902-019-0360-9
  • • Bagonza, J., Rutebemberwa, E. & Bazeyo, W. (2015). Adherence to anti-diabetic medication among patients with diabetes in eastern Uganda; a cross sectional study. BMC Health Services Research, 15(1), 168. https://doi:10.1186/s12913-015-0820-5
  • • Bertoni, A. G., Krop, J. S., Anderson, G. F. & Brancati, F. L. (2002). Diabetes-related morbidity and mortality in a national sample of U.S. elders. Diabetes Care, 25(3), 471-475. https://doi:10.2337/diacare. 25.3.471
  • • Bi, Y., Wang, T., Xu, M., Xu, Y., Li, M., Lu, J. …Ning, G. (2012). Advanced research on risk factors of type 2 diabetes. Diabetes Metabolism Research and Reviews, 28(Suppl. 2), 32-39. https:// doi:10.1002/dmrr.2352
  • • Capoccia, K., Odegard, P. S. & Letassy, N. (2016). Medication adherence with diabetes medication: a systematic review of the literature. The Diabetes Educator, 42(1), 34-71. https:// doi:10.1177/0145721715619038
  • • Chan, M. (2017). Obesity and diabetes: the slow-motion disaster. Milbank Quarterly, 95(1), 11-14. https://doi:10.1111/1468-0009.12238
  • • Chaudhury, A., Duvoor, C., Reddy Dendi, V. S., Kraleti, S., Chada, A., Ravilla, R. …Mirza, W. (2017). Clinical review of antidiabetic drugs: Implications for type 2 diabetes mellitus management. Frontiers in Endocrinology, 8, 6. https://doi:10.3389/fendo.2017.00006
  • • Chia, L. R., Schlenk, E. A. & Dunbar-Jacob, J. (2006). Effect of personal and cultural beliefs on medication adherence in the elderly. Drugs & Aging, 23(3), 191-202. https://doi:10.2165/00002512-200623030- 00002
  • • Chung, W. W., Chua, S. S., Lai, P. S. M. & Morisky, D. (2015). The Malaysian Medication Adherence Scale (MALMAS): concurrent validity using a clinical measure among people with type 2 diabetes in Malaysia. PLoS One, 10(4), e0124275. https://doi:10.1371/journal. pone.0124275
  • • de Vries McClintock, H. F., Morales, K. H., Small, D. S. & Bogner, H. R. (2016). Patterns of adherence to oral hypoglycemic agents and glucose control among primary care patients with type 2 diabetes. Behavioral Medicine, 42(2), 63-71. https://doi:10.1080/089642 89.2014.904767
  • • Del Brutto, O. H., & Mera, R. M. (2016). The importance of people compliance (social desirability bias) in the assessment of epilepsy prevalence in rural areas of developing countries. Results of the Atahualpa Project. Epilepsia, 57(12), e221-e224. https:// doi:10.1111/epi.13594
  • • Egede, L. E., Gebregziabher, M., Dismuke, C. E., Lynch, C. P., Axon, R. N., Zhao, Y. … Mauldin P. D. (2012). Medication nonadherence in diabetes: longitudinal effects on costs and potential cost savings from improvement. Diabetes Care, 35(Suppl. 1), 2533-2539. https://doi:10.2337/dc12-0572
  • • Egede, L. E., Gebregziabher, M., Echols, C. & Lynch, C. P. (2014). Longitudinal effects of medication nonadherence on glycemic control. Annals of Pharmacotherapy, 48(5), 562-570. https:// doi:10.1177/1060028014526362
  • • Forbes, J. M. & Cooper, M. E. (2013). Mechanisms of diabetic complications. Physiological Reviews, 93(1), 137-188. https:// doi:10.1152/physrev.00045.2011
  • • Grant, R. W. & Kirkman, M. S. (2015). Trends in the evidence level for the American Diabetes Association’s “Standards of Medical Care in Diabetes” from 2005 to 2014. Diabetes Care, 38(1), 6-8. https://doi:10.2337/dc14-2142
  • • Heissam, K., Abuamer, Z., & El-Dahshan, N. (2015). Patterns and obstacles to oral antidiabetic medications adherence among type 2 diabetics in Ismailia, Egypt: a cross section study. Pan African Medical Journal, 20, 177. https://doi:10.11604/pamj.2015.20.177.4025
  • • Ho, P. M., Rumsfeld, J. S., Masoudi, F. A., Reese, D., Linder, R., Ahrens, S. & Magid, D. J. (2006). Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Achieve of Internal Medicine, 166(17), 1836-1841. https:// doi:10.1001/archinte.166.17.1836
  • • Kaiser, A. B., Zhang, N. & Van der Pluijm, W. (2018). Global prevalence of type 2 diabetes over the next ten years (2018-2028). Diabetes, 67 (Suppl. 1), 202. https://doi.org/10.2337/db18-202-LB
  • • Krapek, K., King, K., Warren, S. S., George, K. G., Caputo, D. A., Mihelich, K., … Lubowski, T. J. (2004). Medication adherence and associated hemoglobin A1c in type 2 diabetes. Annals of Pharmacotherapy, 38(9), 1357-1362. https://doi:10.1345/aph.1D612
  • • Lingam, R., & Scott, J. (2002). Treatment non-adherence in affective disorders. Acta Psychiatrica Scandinavica, 105(3), 164-172. https://doi:10.1034/j.1600-0447.2002.1r084.x
  • • Mikhael, E. M., Hussain, S. A., Shawky, N. & Hassali, M. A. (2019). Validity and reliability of anti-diabetic medication adherence scale among patients with diabetes in Baghdad, Iraq: a pilot study. BMJ Open Diabetes Research & Care, 7(1), e000658. https://:doi:10.1136/ bmjdrc-2019-000658
  • • Musenge, E. M., Michelo, C., Mudenda, B., & Manankov, A. (2016). Glycaemic Control and Associated Self-Management Behaviours in Diabetic Outpatients: A Hospital Based Observation Study in Lusaka, Zambia. Journal of Diabetes Research, 2016, 1-9. https:// doi:10.1155/2016/7934654
  • • Nguyen, T. M. U., Caze, A. L. & Cottrell, N. (2014). What are validated self-report adherence scales measuring? a systematic review. British Journal of Clinical Pharmacology, 77(3), 427-445. https:// doi:10.1111/bcp.12194
  • • Ogurtsova, K., da Rocha Fernandes, J. D., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N. H. …Makaroff, L. E. (2017). IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Research and Clinical Practice, 128, 40-50. https:// doi:10.1016/j.diabres.2017.03.024
  • • Polonsky, W. H. & Henry, R. R. (2016). Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors. Patient Preference and Adherence, 2016, 1299- 1307. https://doi:10.2147/PPA.S106821
  • • Sarwar, N., Gao, P., Kondapally Seshasai, S. R., Gobin, R., Kaptoge, S. & Di Angelantonio, E. (2010). The Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet, 375(9733), 2215-2222. https:// doi.org/10.1016/S0140-6736(10)60484-9
  • • Schectman, J. M., Nadkarni, M. M. & Voss, J. D. (2002). The association between diabetes metabolic control and drug adherence in an indigent population. Diabetes Care, 25(6), 1015-1021. https:// doi:10.2337/diacare.25.6.1015
  • • Sodihardjo-Yuen, F., van Dijk, L., Wensing, M., De Smet, P. A. & Teichert, M. (2017). Use of pharmacy dispensing data to measure adherence and identify non-adherence with oral hypoglycemic agents. European Journal of Clinical Pharmacology, 73(2), 205-213. https://doi:10.1007/s00228-016-2149-3
  • • Stirratt, M. J., Dunbar-Jacob, J., Crane, H. M., Simoni, J. M., Czajkowski, S., Hilliardet, M. E. …Nilsen, W. J. (2015). Self-report measures of medication adherence behavior: recommendations on optimal use. Translational Behavioral Medicine, 5(4), 470-482. https://doi:10.1007/s13142-015-0315-2
  • • Stolar, M. (2010). Glycemic control and complications in type 2 diabetes mellitus. American Journal of Medicine, 123(Suppl. 3), S3- S11. https://doi:10.1016/j.amjmed.2009.12.004
  • • Whooley, M. A., Avins, A. L., Miranda, J. & Browner, W. S. (1997). Case-finding instruments for depression. Two questions are as good as many. Journal of General Internal Medicine, 12(7), 439-445. https://doi:10.1046/j.1525-1497.1997.00076.x
  • • Wilke, T., Groth, A., Mueller, S., Reese, D., Linder, R., Ahrens, S. & Frank Verheyen, F. (2013). How to use pharmacy claims data to measure patient nonadherence? The example of oral diabetics in therapy of type 2 diabetes mellitus. The European Journal of Health Economics, 14(3), 551-568. https://doi:10.1007/s10198- 012-0410-y
There are 35 citations in total.

Details

Primary Language English
Subjects Pharmacology and Pharmaceutical Sciences
Journal Section Original Article
Authors

Saad Abdulrahman Hussain This is me 0000-0002-1909-417X

Haydar Fakhri Al-tukmagi This is me 0000-0002-4174-6074

Zainab Saad Abdulrahman This is me 0000-0002-7644-8093

Maryem Maythem Sadeq This is me 0000-0002-3919-2885

Dania Natheer Hashim This is me 0000-0001-6632-6431

Rand Sabah Kadhim This is me 0000-0002-1733-6382

Mohammed Mahdi Muayad Kubba This is me 0000-0001-6677-0735

Dur Haydar Al-tukmagi This is me 0000-0002-6569-5275

Project Number 4/2019
Publication Date December 29, 2021
Submission Date January 31, 2021
Published in Issue Year 2021 Volume: 51 Issue: 3

Cite

APA Hussain, S. A., Al-tukmagi, H. F., Abdulrahman, Z. S., Sadeq, M. M., et al. (2021). Evaluation of the adherence to antidiabetic medications among Iraqi patients with T2DM using the Iraqi antidiabetic medication adherence scale (IADMAS). İstanbul Journal of Pharmacy, 51(3), 307-312.
AMA Hussain SA, Al-tukmagi HF, Abdulrahman ZS, Sadeq MM, Hashim DN, Kadhim RS, Kubba MMM, Al-tukmagi DH. Evaluation of the adherence to antidiabetic medications among Iraqi patients with T2DM using the Iraqi antidiabetic medication adherence scale (IADMAS). iujp. December 2021;51(3):307-312.
Chicago Hussain, Saad Abdulrahman, Haydar Fakhri Al-tukmagi, Zainab Saad Abdulrahman, Maryem Maythem Sadeq, Dania Natheer Hashim, Rand Sabah Kadhim, Mohammed Mahdi Muayad Kubba, and Dur Haydar Al-tukmagi. “Evaluation of the Adherence to Antidiabetic Medications Among Iraqi Patients With T2DM Using the Iraqi Antidiabetic Medication Adherence Scale (IADMAS)”. İstanbul Journal of Pharmacy 51, no. 3 (December 2021): 307-12.
EndNote Hussain SA, Al-tukmagi HF, Abdulrahman ZS, Sadeq MM, Hashim DN, Kadhim RS, Kubba MMM, Al-tukmagi DH (December 1, 2021) Evaluation of the adherence to antidiabetic medications among Iraqi patients with T2DM using the Iraqi antidiabetic medication adherence scale (IADMAS). İstanbul Journal of Pharmacy 51 3 307–312.
IEEE S. A. Hussain, H. F. Al-tukmagi, Z. S. Abdulrahman, M. M. Sadeq, D. N. Hashim, R. S. Kadhim, M. M. M. Kubba, and D. H. Al-tukmagi, “Evaluation of the adherence to antidiabetic medications among Iraqi patients with T2DM using the Iraqi antidiabetic medication adherence scale (IADMAS)”, iujp, vol. 51, no. 3, pp. 307–312, 2021.
ISNAD Hussain, Saad Abdulrahman et al. “Evaluation of the Adherence to Antidiabetic Medications Among Iraqi Patients With T2DM Using the Iraqi Antidiabetic Medication Adherence Scale (IADMAS)”. İstanbul Journal of Pharmacy 51/3 (December 2021), 307-312.
JAMA Hussain SA, Al-tukmagi HF, Abdulrahman ZS, Sadeq MM, Hashim DN, Kadhim RS, Kubba MMM, Al-tukmagi DH. Evaluation of the adherence to antidiabetic medications among Iraqi patients with T2DM using the Iraqi antidiabetic medication adherence scale (IADMAS). iujp. 2021;51:307–312.
MLA Hussain, Saad Abdulrahman et al. “Evaluation of the Adherence to Antidiabetic Medications Among Iraqi Patients With T2DM Using the Iraqi Antidiabetic Medication Adherence Scale (IADMAS)”. İstanbul Journal of Pharmacy, vol. 51, no. 3, 2021, pp. 307-12.
Vancouver Hussain SA, Al-tukmagi HF, Abdulrahman ZS, Sadeq MM, Hashim DN, Kadhim RS, Kubba MMM, Al-tukmagi DH. Evaluation of the adherence to antidiabetic medications among Iraqi patients with T2DM using the Iraqi antidiabetic medication adherence scale (IADMAS). iujp. 2021;51(3):307-12.
 Download Cover Image