{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:32:44Z","timestamp":1777984364954,"version":"3.51.4"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"DOI":"10.1186\/s12875-026-03267-9","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T12:05:59Z","timestamp":1773662759000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anti-diabetic medication adherence among adults with type 2 diabetes in eastern Uganda: prevalence, associated factors, barriers, facilitators, and strategies for improvement: a mixed-methods study"],"prefix":"10.1186","volume":"27","author":[{"given":"Brenda","family":"Lalam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Ezatiru","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Michael","family":"Okusa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safina","family":"Akello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Opito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Lubogo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Eleku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shamim","family":"Nabidda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Kabwigu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8295-0744","authenticated-orcid":false,"given":"Samuel","family":"Okello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"3267_CR1","unstructured":"Statista. Diabetes - Statistics & Facts. In.; 2025. https:\/\/www.statista.com\/topics\/1723\/diabetes\/#topicOverview."},{"key":"3267_CR2","unstructured":"Diabetes facts. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diabetes."},{"issue":"1","key":"3267_CR3","doi-asserted-by":"publisher","first-page":"107","DOI":"10.2991\/jegh.k.191028.001","volume":"10","author":"MAB Khan","year":"2020","unstructured":"Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of Type 2 Diabetes - Global Burden of Disease and Forecasted Trends. J Epidemiol Glob Health. 2020;10(1):107\u201311.","journal-title":"J Epidemiol Glob Health"},{"key":"3267_CR4","doi-asserted-by":"publisher","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","volume":"183","author":"H Sun","year":"2022","unstructured":"Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, Stein C, Basit A, Chan JC, Mbanya JC. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119.","journal-title":"Diabetes Res Clin Pract"},{"key":"3267_CR5","doi-asserted-by":"publisher","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","volume":"183","author":"H Sun","year":"2022","unstructured":"Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, Stein C, Basit A, Chan JCN, Mbanya JC, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119.","journal-title":"Diabetes Res Clin Pract"},{"key":"3267_CR6","doi-asserted-by":"publisher","first-page":"503437","DOI":"10.1016\/j.mrgentox.2021.503437","volume":"874\u20135","author":"JEBF Lima","year":"2022","unstructured":"Lima JEBF, Moreira NCS, Sakamoto-Hojo ET. Mechanisms underlying the pathophysiology of type 2 diabetes: From risk factors to oxidative stress, metabolic dysfunction, and hyperglycemia. Mutat Research\/Genetic Toxicol Environ Mutagen. 2022;874\u20135:503437.","journal-title":"Mutat Research\/Genetic Toxicol Environ Mutagen"},{"key":"3267_CR7","unstructured":"MoH. Uganda Clinical Guideline. National guideline for management of common health conditions; 2023. https:\/\/nms.go.ug\/wp-content\/uploads\/2025\/12\/Uganda-Clinical-Guidelines-20231.pdf."},{"issue":"11","key":"3267_CR8","doi-asserted-by":"publisher","first-page":"1614","DOI":"10.1111\/jdi.14285","volume":"15","author":"K Boonpattharatthiti","year":"2024","unstructured":"Boonpattharatthiti K, Songkla PN, Chantara J, Koomsri C, Krass I, Chaiyakunapruk N, Dhippayom T. Prevalence of adherence to oral antidiabetic drugs in patients with type 2 diabetes: A systematic review and meta-analysis. J Diabetes Investig. 2024;15(11):1614\u201325.","journal-title":"J Diabetes Investig"},{"key":"3267_CR9","unstructured":"Medication adherence in patients with type 2 diabetes. Barriers & interventions. https:\/\/acarepro.abbott.com\/articles\/cardio-metabolic\/medication-adherence-in-type-diabetes\/."},{"key":"3267_CR10","doi-asserted-by":"crossref","unstructured":"Piragine E, Petri D, Martelli A, Calderone V, Lucenteforte E. Adherence to Oral Antidiabetic Drugs in Patients with Type 2 Diabetes: Systematic Review and Meta-Analysis. J Clin Med. 2023;12(5).","DOI":"10.3390\/jcm12051981"},{"key":"3267_CR11","unstructured":"Federation ID. Diabetes in Africa. Prevalence of Diabetes (20\u201379 years). In.; 2021. https:\/\/diabetesatlas.org\/media\/uploads\/sites\/3\/2025\/02\/IDF-Atlas-Factsheet-2021_AFR.pdf."},{"issue":"8","key":"3267_CR12","first-page":"270","volume":"11","author":"OQ Al-lela","year":"2020","unstructured":"Al-lela OQ, Abdulkareem RA, AL-Mufti L, Kamal N, Qasim S, Sagvan R, Hinir Z, Khidr H. Medication adherence among diabetic patients in developing countries: review of studies. Syst Rev Pharm. 2020;11(8):270\u20135.","journal-title":"Syst Rev Pharm"},{"key":"3267_CR13","unstructured":"Facts about diabetes mellitus in Uganda. https:\/\/idf.org\/our-network\/regions-and-members\/africa\/members\/uganda\/uganda-diabetes-association\/."},{"key":"3267_CR14","doi-asserted-by":"publisher","first-page":"479","DOI":"10.2147\/PPA.S343736","volume":"16","author":"K Faisal","year":"2022","unstructured":"Faisal K, Tusiimire J, Yadesa TM. Prevalence and Factors Associated with Non-Adherence to Antidiabetic Medication Among Patients at Mbarara Regional Referral Hospital, Mbarara, Uganda. Patient Prefer Adherence. 2022;16:479\u201391.","journal-title":"Patient Prefer Adherence"},{"issue":"1","key":"3267_CR15","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s12902-019-0360-9","volume":"19","author":"LN Aminde","year":"2019","unstructured":"Aminde LN, Tindong M, Ngwasiri CA, Aminde JA, Njim T, Fondong AA, Takah NF. Adherence to antidiabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocr Disord. 2019;19(1):35.","journal-title":"BMC Endocr Disord"},{"key":"3267_CR16","doi-asserted-by":"publisher","unstructured":"Qutubuddin M, Rahman RA, Ghafoor E, Riaz M, Khan R. Assessment of factors associated with non-compliance to self-management practices in people with type 2 diabetes. Cureus. 2021;13(10). https:\/\/doi.org\/10.7759\/cureus.18918.","DOI":"10.7759\/cureus.18918"},{"issue":"6","key":"3267_CR17","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.2337\/dc05-2494","volume":"29","author":"RR Rubin","year":"2006","unstructured":"Rubin RR, Peyrot M, Siminerio LM, Panel IDA. Health care and patient-reported outcomes: results of the cross-national Diabetes Attitudes, Wishes and Needs (DAWN) study. Diabetes Care. 2006;29(6):1249\u201355.","journal-title":"Diabetes Care"},{"key":"3267_CR18","doi-asserted-by":"publisher","unstructured":"Polonsky WH, Henry RR. Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors. Patient Prefer Adherence. 2016:1299\u2013307. https:\/\/doi.org\/10.2147\/PPA.S106821.","DOI":"10.2147\/PPA.S106821"},{"key":"3267_CR19","first-page":"525","volume":"7","author":"NS Ahmad","year":"2013","unstructured":"Ahmad NS, Ramli A, Islahudin F, Paraidathathu T. Medication adherence in patients with type 2 diabetes mellitus treated at primary health clinics in Malaysia. Patient Prefer Adherence. 2013;7:525\u201330.","journal-title":"Patient Prefer Adherence"},{"key":"3267_CR20","unstructured":"Creswell JW, Creswell JD. Research Design: Quantitative, Qualitative and Mixed Methods Approaches. Sixth edn. 2023. https:\/\/www.academia.edu\/57201640\/Creswell_J_W_2014_Research_Design_Qualitative_Quantitative_and_Mixed_Methods_Approaches_4th_ed_Thousand_Oaks_CA_Sage."},{"key":"3267_CR21","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1186\/s12913-015-0820-5","volume":"15","author":"J Bagonza","year":"2015","unstructured":"Bagonza J, Rutebemberwa E, Bazeyo W. Adherence to anti diabetic medication among patients with diabetes in eastern Uganda; a cross sectional study. BMC Health Serv Res. 2015;15:168.","journal-title":"BMC Health Serv Res"},{"issue":"8","key":"3267_CR22","doi-asserted-by":"publisher","first-page":"e0237710","DOI":"10.1371\/journal.pone.0237710","volume":"15","author":"RA Afaya","year":"2020","unstructured":"Afaya RA, Bam V, Azongo TB, Afaya A, Kusi-Amponsah A, Ajusiyine JM, Abdul Hamid T. Medication adherence and self-care behaviours among patients with type 2 diabetes mellitus in Ghana. PLoS ONE. 2020;15(8):e0237710.","journal-title":"PLoS ONE"},{"issue":"11\u201312","key":"3267_CR23","doi-asserted-by":"publisher","first-page":"2296","DOI":"10.1111\/jocn.14835","volume":"28","author":"V Mogre","year":"2019","unstructured":"Mogre V, Johnson NA, Tzelepis F, Paul C. Barriers to diabetic self-care: A qualitative study of patients\u2019 and healthcare providers\u2019 perspectives. J Clin Nurs. 2019;28(11\u201312):2296\u2013308.","journal-title":"J Clin Nurs"},{"issue":"1","key":"3267_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/109019818401100101","volume":"11","author":"NK Janz","year":"1984","unstructured":"Janz NK, Becker MH. The Health Belief Model: a decade later. Health Educ Q. 1984;11(1):1\u201347.","journal-title":"Health Educ Q"},{"issue":"3","key":"3267_CR25","doi-asserted-by":"publisher","first-page":"e32412","DOI":"10.1371\/journal.pone.0032412","volume":"7","author":"M Tiv","year":"2012","unstructured":"Tiv M, Viel J-F, Mauny F, Eschw\u00e8ge E, Weill A, Fournier C, Fagot-Campagna A, Penfornis A. Medication Adherence in Type 2 Diabetes: The ENTRED Study 2007, a French Population-Based Study. PLoS ONE. 2012;7(3):e32412.","journal-title":"PLoS ONE"},{"issue":"1","key":"3267_CR26","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s13031-020-00336-3","volume":"15","author":"CH Logie","year":"2021","unstructured":"Logie CH, Okumu M, Latif M, Musoke DK, Odong Lukone S, Mwima S, Kyambadde P. Exploring resource scarcity and contextual influences on wellbeing among young refugees in Bidi Bidi refugee settlement, Uganda: findings from a qualitative study. Confl Health. 2021;15(1):3.","journal-title":"Confl Health"},{"key":"3267_CR27","unstructured":"Ongugo RA. Contributors of non-adherence to type Ii diabetes treatment among patients at Thogoto hospital in Kiambu County, Kenya. Kenyatta University. 2008. https:\/\/ir-library.ku.ac.ke\/server\/api\/core\/bitstreams\/9ff9d755-3b49-490d-9107-45cf108f0ad9\/content."},{"issue":"1","key":"3267_CR28","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1186\/s12902-022-01133-0","volume":"22","author":"JD Murwanashyaka","year":"2022","unstructured":"Murwanashyaka JD, Ndagijimana A, Biracyaza E, Sunday FX, Umugwaneza M. Non-adherence to medication and associated factors among type 2 diabetes patients at Clinique Medicale Fraternite, Rwanda: a cross-sectional study. BMC Endocr disorders. 2022;22(1):219.","journal-title":"BMC Endocr disorders"},{"issue":"1","key":"3267_CR29","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s13012-019-0892-4","volume":"14","author":"TJ Waltz","year":"2019","unstructured":"Waltz TJ, Powell BJ, Fern\u00e1ndez ME, Abadie B, Damschroder LJ. Choosing implementation strategies to address contextual barriers: diversity in recommendations and future directions. Implement Sci. 2019;14(1):42.","journal-title":"Implement Sci"},{"issue":"6","key":"3267_CR30","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1377\/hlthaff.20.6.64","volume":"20","author":"EH Wagner","year":"2001","unstructured":"Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001;20(6):64\u201378.","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"3267_CR31","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1186\/s12913-024-11448-4","volume":"24","author":"AS Ssemata","year":"2024","unstructured":"Ssemata AS, Smythe T, Sande S, Menya A, Hameed S, Waiswa P, Mbazzi FB, Kuper H. Suggested solutions to barriers in accessing healthcare by persons with disability in Uganda: a qualitative study. BMC Health Serv Res. 2024;24(1):1010.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"3267_CR32","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1186\/s43058-023-00532-1","volume":"4","author":"LE Balis","year":"2023","unstructured":"Balis LE, Houghtaling B. Matching barriers and facilitators to implementation strategies: recommendations for community settings. Implement Sci Commun. 2023;4(1):144.","journal-title":"Implement Sci Commun"},{"key":"3267_CR33","unstructured":"Uganda National Household Survey. 2023\/24 Report. https:\/\/www.ubos.org\/wp-content\/uploads\/publications\/Uganda-National-Household-Survey-Report-20232024.pdf?utm_source=chatgpt.com."}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-026-03267-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03267-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03267-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T23:59:53Z","timestamp":1776902393000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12875-026-03267-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,16]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3267"],"URL":"https:\/\/doi.org\/10.1186\/s12875-026-03267-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-8097219\/v1","asserted-by":"object"}]},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,16]]},"assertion":[{"value":"12 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. The study protocol was reviewed and approved by the Mbale Regional Referral Hospital Research Ethics Committee (MRRH-2025-557). Written informed consent was obtained from all participants. Participation was voluntary, and confidentiality and anonymity were maintained throughout the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"152"}}