Mesure de l’observance therapeutique chez les patients diabetiques suivis a l’hopital militaire d’Abidjan.

Introduction: Diabetes is a chronic disease; diabetes treatment adherence remains an important factor for improving the care of the diabetic patient. The aim of our study was to measure the compliance of the antidiabetic therapy in diabetic patients treated at the military hospital of Abidjan (HMA). Materials and Methods: This is a prospective cross-sectional study of diabetic patients seen in the department of internal medicine of HMA from 1 March to 31 August 2011. The patients answered a standardized questionnaire on adherence called TEO. Thus the quality of compliance was ranked best, average or poor. To determine the factors that influence adherence, the comparison between the three groups "good compliance", "minimal compliance problems" and "poor compliance" was performed. The statistical tests used were focused on five types of factors identified by the WHO demographic and socio-economic factors related to the patient and / or his entourage, the system of care and disease-related factors to drug treatment. Results: The study included 260 diabetic patients. The quality of compliance was optimal in 117 (45%) patients, average in 56 (21.54%) and poor in 87 (33.46%) patients. In epidemiological terms, male gender, level of education, lack of health insurance and a better doctor-patient relationship were associated with better adherence of diabetes. The therapeutic and evolutionary terms, the best observation group was among the patients with a blood glucose reader, conducting regular monitoring of blood sugar, and having the best of glycated hemoglobin values. By cons, forgetfulness treatment and adverse events were associated with treatment non-adherence and the number of tablets and the number of daily medications were not associated with poor adherence. Conclusion: The results of our study suggest that improving the supply of care, the establishment of a health insurance accessible and patient education could help to improve the quality of patient compliance with diabetes in Cote d'Ivoire.