Predictors of Medication Non-Adherence Among Patients with Type 2 Diabetes Attending Tertiary Hospitals in Kano State

Background: Medication non-adherence among patients with type 2 diabetes is a critical driver of poor glycaemic control and diabetes-related complications in North West Nigeria. Identifying predictors is essential for tailoring nurse-led adherence interventions. Aim: This study determined predictors of medication non-adherence among type 2 diabetes patients at tertiary hospitals in Kano State. Methods: An analytical cross-sectional study recruited 230 patients through systematic random sampling at two teaching hospitals. The Morisky Medication Adherence Scale, Hill-Bone Compliance Scale, and a sociodemographic questionnaire were used. Binary logistic regression identified independent predictors. Results: Non-adherence was identified in 61% of participants. Independent predictors included polypharmacy, high medication costs, poor nurse counselling quality, forgetfulness, and fear of hypoglycaemia. Patients who received structured nurse education at their last clinic visit had significantly higher adherence odds. Conclusion: Modifiable predictors, especially nurse counselling quality and medication cost, should be central to adherence intervention design. Nurse-led adherence support, subsidised medication access, and simplified medication regimens are key policy recommendations. Keywords: medication adherence, type 2 diabetes, Kano, predictors, nurse counselling.