THE IMPACT OF MEDICATION ADHERENCE AND GLYCEMIC CONTROL ON PAIN SEVERITY AMONG PATIENTS WITH DIABETES MELLITUS: A CROSS-SECTIONAL STUDY FROM PALESTINE

Abstract

Background: The evaluation of pain and medication compliance in patients with type 2 diabetes mellitus is essential for efficient illness management. This study aimed to assess the relationships between medication adherence and the severity of pain among diabetic patients and their glycemic control. Methods: This study was conducted with a cross-sectional design. The study used the Arabic versions of the Brief Pain Inventory Scale and the Medication Adherence Rating Scale. The patients were included from different healthcare centers in Nablus city. The data were collected via a structured questionnaire. Results: In this study, 377 patients were included. Of those, 244 (64.7%) were female. The median age of the patients was 62.0 [IQR: 55.5, 68.0] years. The median time since diagnosis of type 2 diabetes mellitus was 8.0 [IQR: 4.0, 15.0] years, and the HbA1c level was 7.8% [IQR: 6.8%, 9.0%]. Among the patients, 162 (43.0%) had no pain, 92 (24.4%) had mild pain, 43 (11.4%) had moderate pain, and 80 (21.2%) had severe pain. The median adherence score was 8.0 [7.0, 9.0]. Pain severity scores were predicted by living in refugee camps, lacking formal education, having hypertension, experiencing elbow pain, experiencing knee pain, using ibuprofen orphenadrine, and having higher pain interference scores. Pain interference scores were predicted by being female, being a housewife, using Aspart, smoking more cigarettes/day, having elbow pain, knee pain, calf pain, using paracetamol, and having higher pain severity scores. Medication adherence scores were predicted by not using human insulin (p = 0.034), using glimepiride (p = 0.005), not using nitrates (p = 0.039), and having pain in both hands (p = 0.045). Conclusions: This research emphasizes the interconnected difficulties of pain management and medication compliance among type 2 diabetes mellitus patients in the Palestinian healthcare system. Resolving these difficulties requires a holistic strategy that integrates clinical, community, and policy-level initiatives. Focusing on fair access to treatment, patient education, and evidence-based procedures may lead to substantial improvements in patient outcomes. Future research should investigate the sustained effectiveness of suggested treatments and the feasibility of expanding successful programs to other locations. Keywords: Adherence, Diabetes mellitus, Medications, Insulin, Pain, Quality of life, Outcomes