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. 2024 Aug 22;16(8):e67509.
doi: 10.7759/cureus.67509. eCollection 2024 Aug.

Impact of Socio-Demographics and Knowledge, Attitudes, and Practices (KAP) on Misconceptions of Metformin Use in Diabetes: A Potential Myth and Disbelief in South Asia

Liyana Arachchi Chanika Rangani  1 , Balapuwaduge Isuru Layan M Mendis  2 , Harshini Rajapakse  3 , Arosha Dissanayake  2
Affiliations

Impact of Socio-Demographics and Knowledge, Attitudes, and Practices (KAP) on Misconceptions of Metformin Use in Diabetes: A Potential Myth and Disbelief in South Asia

Liyana Arachchi Chanika Rangani et al. Cureus. .

Abstract

Background: The influence of misconceptions and related socio-demographics on metformin use could hamper adherence to medications. This study aimed to assess the rates and causes of metformin non-adherence and to investigate knowledge, attitudes, and practices (KAP) on misconceptions of metformin use including the association with socio-demographic variables.

Methods: An observational analytical cross-sectional study was conducted at the diabetes clinic of Karapitiya Teaching Hospital in Galle, Sri Lanka. Causes of metformin non-adherence, associations with socio-demographics, and KAP on misconceptions on metformin use were assessed using the chi-squared test, t-tests, and ANOVA using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States) (p<0.05).

Results: Metformin non-adherence was reported as 55%. Use of complementary and alternative therapies was 14.7%. Fear of major organ failure was the commonest (20.5%) reason quoted within the non-adherence group (N=223). Socio-demographic factors like ethnicity, lower education, unemployment, use of complementary and alternative therapies, and obtaining medications for other diabetes-related diseases significantly influenced adherence to the metformin-prescribed doses (p<0.05). Among all participants (N=400), the most common misconception was that long-term use of metformin caused organ damage (kidney 72.5%, liver 64.3%, and heart 34.8%), while 44% believed higher doses (two tablets or more for a day) caused organ damage. The KAP scores were reported as 24.5% with low, 52.7% moderate, and 22.7% satisfactory levels. Significantly lower KAP scores were associated with lower education levels and patients obtaining complementary and alternative therapies (p<0.05).

Conclusion: Misconceptions are not merely kept in mind but lead to non-adherence with metformin doses prescribed and warrant evidence-based educational interventions with the high-risk groups.

Keywords: adherence; compliance; diabetes mellitus; medications; metformin.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Ethical Review Committee of the Faculty of Allied Health Sciences, University of Ruhuna issued approval 14.02.2018:21. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Galle Divisional Secretariat Division's population distribution
Figure 2
Figure 2. Numeric scale of assessing KAP of metformin use
KAP: knowledge, attitudes, and practices
Figure 3
Figure 3. Adherence to the prescribed doses of metformin
Figure 4
Figure 4. Frequency distribution of KAP scores
KAP: knowledge, attitudes, and practices
See this image and copyright information in PMC

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