SUN-661 - From Beliefs to Behavior: Determinants of Medication Adherence in Type 2 Diabetes

Background:
Medication adherence remains a major challenge in the management of type 2 diabetes mellitus (T2DM), particularly in low- and middle-income settings. Cultural beliefs about medications and socioeconomic factors may significantly influence adherence behaviors, yet evidence describing these determinants across diverse clinical contexts remains limited.

Methods:
We conducted a prospective, cross-sectional observational study at a secondary-level public hospital in northeastern Mexico between October 2024 and April 2025. Adult patients with established T2DM were enrolled during hospitalization under Internal Medicine care. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Beliefs about medications were evaluated with the Beliefs about Medicines Questionnaire (BMQ), including specific and general subscales. Socioeconomic status was classified using the AMAI 2022 index. Descriptive statistics and exploratory bivariate and multivariable logistic regression analyses were performed.

Results:
Eighty-eight patients were included (median age 53.5 years; 63.6% female). Low medication adherence was observed in 69.3% of participants. Higher scores on the BMQ harm subscale were significantly associated with lower adherence, whereas stronger perceptions of medication necessity were positively associated with moderate-to-high adherence after adjustment for age, sex, and clinical variables. Socioeconomic status was not independently associated with adherence levels. In exploratory regression models, medication-related beliefs emerged as stronger predictors of adherence than demographic or clinical variables.

Conclusions:
In adults with T2DM, medication adherence was suboptimal and appeared to be more strongly influenced by beliefs about medications than by socioeconomic status alone. These findings highlight the relevance of addressing patient beliefs as part of routine diabetes care and support the use of hospitalization as a strategic opportunity to identify adherence barriers and inform interventions aimed at improving long-term adherence and metabolic outcomes across care settings.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*